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Systematic screening using FRAX leads to increased use of, and adherence to, anti-osteoporosis medications: An analysis of the UK SCOOP Trial

Systematic screening using FRAX leads to increased use of, and adherence to, anti-osteoporosis medications: An analysis of the UK SCOOP Trial
Systematic screening using FRAX leads to increased use of, and adherence to, anti-osteoporosis medications: An analysis of the UK SCOOP Trial
Summary In the large community-based SCOOP trial, systematic fracture risk screening using FRAX® led to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care. Introduction In the SCreening of Older wOmen for Prevention of fracture (SCOOP) trial, we investigated the effect of the screening intervention on subsequent long-term self-reported adherence to anti-osteoporosis medications (AOM). Methods SCOOP was a primary care–based UK multicentre trial of screening for fracture risk. A total of 12,483 women (70–85 years) were randomised to either usual NHS care, or assessment using the FRAX® tool ± dual-energy X-ray absorptiometry (DXA), with medication recommended for those found to be at high risk of hip fracture. Self-reported AOM use was obtained by postal questionnaires at 6, 12, 24, 36, 48 and 60 months. Analysis was limited to those who initiated AOM during follow-up. Logistic regression was used to explore baseline determinants of adherence (good ≥ 80%; poor < 80%). Results The mean (SD) age of participants was 75.6 (4.2) years, with 6233 randomised to screening and 6250 to the control group. Of those participants identified at high fracture risk in the screening group, 38.2% of those on treatment at 6 months were still treated at 60 months, whereas the corresponding figure for the control group was 21.6%. Older age was associated with poorer adherence (OR per year increase in age 0.96 [95% CI 0.93, 0.99], p = 0.01), whereas history of parental hip fracture was associated with greater rate adherence (OR 1.67 [95% CI 1.23, 2.26], p < 0.01). Conclusions Systematic fracture risk screening using FRAX® leads to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care.
0937-941X
1-9
Parsons, C.
9730e5c3-0382-4ed7-8eaa-6932ab09ec15
Harvey, N.
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Shepstone, L.
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Kanis, J.A,
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Lenaghan, E.
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Clarke, S.
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Fordham, R.
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Gittoes, N.M.
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Harvey, I.
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Holland, R.
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Redmond, N.M.
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Howe, A.
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Marshall, T.
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Peters, T.J.
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Torgerson, D.
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O'Neill, T.W.
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McCloskey, E.
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Cooper, C.
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SCOOP Study Team
Parsons, C.
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Harvey, N.
ce487fb4-d360-4aac-9d17-9466d6cba145
Shepstone, L.
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Kanis, J.A,
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Lenaghan, E.
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Clarke, S.
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Fordham, R.
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Gittoes, N.M.
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Harvey, I.
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Holland, R.
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Redmond, N.M.
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Howe, A.
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Marshall, T.
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Peters, T.J.
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Torgerson, D.
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O'Neill, T.W.
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McCloskey, E.
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Cooper, C.
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Parsons, C., Harvey, N., Shepstone, L., Kanis, J.A,, Lenaghan, E., Clarke, S., Fordham, R., Gittoes, N.M., Harvey, I., Holland, R., Redmond, N.M., Howe, A., Marshall, T., Peters, T.J., Torgerson, D., O'Neill, T.W., McCloskey, E. and Cooper, C. , SCOOP Study Team (2019) Systematic screening using FRAX leads to increased use of, and adherence to, anti-osteoporosis medications: An analysis of the UK SCOOP Trial. Osteoporosis International, 1-9. (doi:10.1007/s00198-019-05142-z).

Record type: Article

Abstract

Summary In the large community-based SCOOP trial, systematic fracture risk screening using FRAX® led to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care. Introduction In the SCreening of Older wOmen for Prevention of fracture (SCOOP) trial, we investigated the effect of the screening intervention on subsequent long-term self-reported adherence to anti-osteoporosis medications (AOM). Methods SCOOP was a primary care–based UK multicentre trial of screening for fracture risk. A total of 12,483 women (70–85 years) were randomised to either usual NHS care, or assessment using the FRAX® tool ± dual-energy X-ray absorptiometry (DXA), with medication recommended for those found to be at high risk of hip fracture. Self-reported AOM use was obtained by postal questionnaires at 6, 12, 24, 36, 48 and 60 months. Analysis was limited to those who initiated AOM during follow-up. Logistic regression was used to explore baseline determinants of adherence (good ≥ 80%; poor < 80%). Results The mean (SD) age of participants was 75.6 (4.2) years, with 6233 randomised to screening and 6250 to the control group. Of those participants identified at high fracture risk in the screening group, 38.2% of those on treatment at 6 months were still treated at 60 months, whereas the corresponding figure for the control group was 21.6%. Older age was associated with poorer adherence (OR per year increase in age 0.96 [95% CI 0.93, 0.99], p = 0.01), whereas history of parental hip fracture was associated with greater rate adherence (OR 1.67 [95% CI 1.23, 2.26], p < 0.01). Conclusions Systematic fracture risk screening using FRAX® leads to greater use of AOM and greater adherence, in women at high fracture risk, compared with usual care.

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SCOOP med adherence Manuscript - OI reviewer - Accepted Manuscript
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Accepted/In Press date: 20 August 2019
e-pub ahead of print date: 12 October 2019

Identifiers

Local EPrints ID: 433607
URI: http://eprints.soton.ac.uk/id/eprint/433607
ISSN: 0937-941X
PURE UUID: b4858702-5d40-405d-8c6f-a02fc96d3910
ORCID for N. Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 28 Aug 2019 16:30
Last modified: 26 Nov 2021 06:52

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Contributors

Author: C. Parsons
Author: N. Harvey ORCID iD
Author: L. Shepstone
Author: J.A, Kanis
Author: E. Lenaghan
Author: S. Clarke
Author: R. Fordham
Author: N.M. Gittoes
Author: I. Harvey
Author: R. Holland
Author: N.M. Redmond
Author: A. Howe
Author: T. Marshall
Author: T.J. Peters
Author: D. Torgerson
Author: T.W. O'Neill
Author: E. McCloskey
Author: C. Cooper ORCID iD
Corporate Author: SCOOP Study Team

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