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Patient preferences for lifestyle behaviours in osteoporotic fracture prevention: a cross-European discrete choice experiment

Patient preferences for lifestyle behaviours in osteoporotic fracture prevention: a cross-European discrete choice experiment
Patient preferences for lifestyle behaviours in osteoporotic fracture prevention: a cross-European discrete choice experiment
Summary: using a discrete choice experiment, we aimed to assess patients’ preferences with regard to adopting lifestyle behaviours to prevent osteoporotic fractures. Overall, the 1042 patients recruited from seven European countries were favourable to some lifestyle behaviours (i.e., engaging in moderate physical activity, taking calcium and vitamin D supplements, reducing their alcohol consumption and ensuring a normal body weight).

Introduction: alongside medical therapy, healthy lifestyle habits are recommended for preventing osteoporotic fractures. In this study, we aimed to assess patients’ preferences with regard to adopting lifestyle changes to prevent osteoporotic fractures.

Methods: a discrete choice experiment was conducted in seven European countries. Patients with or at risk of osteoporosis were asked to indicate to what extent they would be motivated to adhere to 16 lifestyle packages that differed in various levels of 6 attributes. The attributes and levels proposed were physical activity (levels: not included, moderate or high), calcium and vitamin D status (levels: not included, taking supplements, improving nutrition and assuring a minimal exposure to sunlight daily), smoking (levels: not included, quit smoking), alcohol (levels: not included, moderate consumption), weight reduction (levels: not included, ensure a healthy body weight) and fall prevention (levels: not included, receiving general advice or following a 1-day fall prevention program). A conditional logit model was used to estimate a patient’s relative preferences for the various attributes across all participants and per country.

Results: in total, 1042 patients completed the questionnaire. Overall, patients were favourable to lifestyle behaviours for preventing osteoporotic fractures. However, among the lifestyle behaviours proposed, patients were consensually not prone to engage in a high level of physical activity. In addition, in Ireland, Belgium, the Netherlands and Switzerland, patients were also not inclined to participate in a 1-day fall prevention program and Belgian, Swiss and Dutch patients were not prone to adhere to a well-balanced nutritional program. Nevertheless, we observed globally that patients felt positively about reducing their alcohol consumption, engaging in moderate physical activity, taking calcium and vitamin D supplements and ensuring a normal body weight, all measures aimed at preventing fractures.

Conclusions: in a patient-centred approach, fracture prevention should take these considerations and preferences into account.
Discrete choice experiment, Fractures, Lifestyle, Osteoporosis, Patients’ preferences
0937-941X
1335-1346
Beaudart, Charlotte
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Boonen, Annelies
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Li, Nannan
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Bours, Sandrine
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Goemeare, Stefan
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Reginster, Jean Yves
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Roux, Christian
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McGowan, Bernie
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Diez-Pérez, A.
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Rizzoli, Rene
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Cooper, Cyrus
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Hiligsmann, Mickaël
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Beaudart, Charlotte
bdc9da98-791a-474b-9745-be0695a4d8a9
Boonen, Annelies
c32bd0a4-48b2-45f9-9ab3-5ff0074b7f32
Li, Nannan
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Bours, Sandrine
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Goemeare, Stefan
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Reginster, Jean Yves
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Roux, Christian
1f852839-8036-423f-ade1-a003d42271fa
McGowan, Bernie
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Diez-Pérez, A.
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Rizzoli, Rene
e02c0d92-6da1-430c-a669-0c20e94a850a
Cooper, Cyrus
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Hiligsmann, Mickaël
120a5b99-2a0a-4a17-99d1-c0e5147d4f59

Beaudart, Charlotte, Boonen, Annelies, Li, Nannan, Bours, Sandrine, Goemeare, Stefan, Reginster, Jean Yves, Roux, Christian, McGowan, Bernie, Diez-Pérez, A., Rizzoli, Rene, Cooper, Cyrus and Hiligsmann, Mickaël (2022) Patient preferences for lifestyle behaviours in osteoporotic fracture prevention: a cross-European discrete choice experiment. Osteoporosis International, 33 (6), 1335-1346. (doi:10.1007/s00198-022-06310-4).

Record type: Article

Abstract

Summary: using a discrete choice experiment, we aimed to assess patients’ preferences with regard to adopting lifestyle behaviours to prevent osteoporotic fractures. Overall, the 1042 patients recruited from seven European countries were favourable to some lifestyle behaviours (i.e., engaging in moderate physical activity, taking calcium and vitamin D supplements, reducing their alcohol consumption and ensuring a normal body weight).

Introduction: alongside medical therapy, healthy lifestyle habits are recommended for preventing osteoporotic fractures. In this study, we aimed to assess patients’ preferences with regard to adopting lifestyle changes to prevent osteoporotic fractures.

Methods: a discrete choice experiment was conducted in seven European countries. Patients with or at risk of osteoporosis were asked to indicate to what extent they would be motivated to adhere to 16 lifestyle packages that differed in various levels of 6 attributes. The attributes and levels proposed were physical activity (levels: not included, moderate or high), calcium and vitamin D status (levels: not included, taking supplements, improving nutrition and assuring a minimal exposure to sunlight daily), smoking (levels: not included, quit smoking), alcohol (levels: not included, moderate consumption), weight reduction (levels: not included, ensure a healthy body weight) and fall prevention (levels: not included, receiving general advice or following a 1-day fall prevention program). A conditional logit model was used to estimate a patient’s relative preferences for the various attributes across all participants and per country.

Results: in total, 1042 patients completed the questionnaire. Overall, patients were favourable to lifestyle behaviours for preventing osteoporotic fractures. However, among the lifestyle behaviours proposed, patients were consensually not prone to engage in a high level of physical activity. In addition, in Ireland, Belgium, the Netherlands and Switzerland, patients were also not inclined to participate in a 1-day fall prevention program and Belgian, Swiss and Dutch patients were not prone to adhere to a well-balanced nutritional program. Nevertheless, we observed globally that patients felt positively about reducing their alcohol consumption, engaging in moderate physical activity, taking calcium and vitamin D supplements and ensuring a normal body weight, all measures aimed at preventing fractures.

Conclusions: in a patient-centred approach, fracture prevention should take these considerations and preferences into account.

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Accepted/In Press date: 12 January 2022
e-pub ahead of print date: 22 January 2022
Published date: June 2022
Additional Information: Funding Information: JYR has received research grant and/or consulting fees from Servier, Novartis, Negma, Lilly, Wyeth, Amgen, GlaxoSmithKline, Roche, Merckle, Nycomed-Takeda, NPS, IBSA Genevrier, Theramex, UCB, Asahi Kasei, Endocyte, Merck Sharp and Dohme, Rottapharm, Teijin, Teva, Analis, NovoNordisk, Ebewee Pharma, Zodiac, Danone, Will Pharma, Meda, Bristol Myers Squibb, Pfizer, Organon, Therabel, Boehringer, Chiltern, Galapagos. SG has received lecture fees from Amgen and consulting fees from the advisory board of UCB. AD-P has been a speaker or advisor for Amgen, Lilly, Theramex and Active Life Scientific. RR has received consulting fees from the advisory boards of Abiogen, Amgen, Danone, Echolight, European Milk Forum, Nestlé, ObsEva, Pfizer Consumer Health, Radius Health and Theramex. BW has received speaker or consulting fees from advisory boards of Abbvie, Pfizer, Merck Sharp and Dohme, Menarini and Novartis Pharmaceuticals. The remaining authors state that they have no competing interests relevant to this study. Funding Information: We would like to thank all participating centres: the Unit for Osteoporosis and Metabolic Bone from Ghent University Hospital (Belgium); the University Center for Investigation in Bone and Articular Cartilage Metabolism in Liège (Belgium); the Fracture Clinic of Maastricht University Medical Center (the Netherlands); the Bone Unit of Paris Descartes University, Paris (France); the North Western Rheumatology Unit, Our Lady’s Hospital, Manorhamilton and Sligo University Hospital (Ireland); the Musculoskeletal Research Unit and RETICEF from the Universitat Autònoma de Barcelona (Spain); the Division of Bone Diseases from the Geneva University Hospitals (Switzerland); the MRC Lifecourse Epidemiology Unit from the University of Southampton (UK) for helping us in data collection; Ed Porquie, our patient partner; Wafa Ben Sedrine, Ivette Essers and Wilco Tilburgs for data entry; and all the patients for their participation. Funding Information: This study was part of a project funded by Amgen. The funding agreement between Maastricht University and Amgen ensured the authors’ independence in designing the study (including selection of attributes and levels), interpreting the data, and writing and publishing the report. Other participating centres were compensated by Maastricht University for their participation in the study. Publisher Copyright: © 2022, The Author(s).
Keywords: Discrete choice experiment, Fractures, Lifestyle, Osteoporosis, Patients’ preferences

Identifiers

Local EPrints ID: 454686
URI: http://eprints.soton.ac.uk/id/eprint/454686
ISSN: 0937-941X
PURE UUID: 7cf9f83a-6080-481b-adaa-8b1bf3da7b25
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 21 Feb 2022 17:34
Last modified: 18 Mar 2024 02:47

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Contributors

Author: Charlotte Beaudart
Author: Annelies Boonen
Author: Nannan Li
Author: Sandrine Bours
Author: Stefan Goemeare
Author: Jean Yves Reginster
Author: Christian Roux
Author: Bernie McGowan
Author: A. Diez-Pérez
Author: Rene Rizzoli
Author: Cyrus Cooper ORCID iD
Author: Mickaël Hiligsmann

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