目的:本系统综述旨在评估在二级骨折预防计划中筛选的脆性骨折患者中,接受药物治疗的比例,收到了骨活性药物的处方,并开始了处方药。此外,这项研究旨在通过检查公平相关变量,包括年龄,性别,性别,种族,教育,收入,和地理位置。
方法:我们进行了系统评价,以确定接受二级骨折预防方案处方和/或开始骨活性药物治疗的脆性骨折患者的比例。我们还检查了研究中报告的治疗适应症和资格标准,以确认有资格接受治疗的患者。计算药物处方和开始的合并比例,我们进行了单组比例荟萃分析.我们还根据年龄提取了接受处方和/或开始治疗的患者比例,性别,种族,教育,社会经济地位,location,和慢性病。
结果:本综述包括122项研究,涵盖114个项目。合并处方率为77%,估计的药物起始率为71%。亚组分析显示,骨折联络处和其他计划之间的治疗开始没有显着差异。在所有研究中,年龄,性别,和社会经济地位是唯一报告的与治疗结果相关的公平变量.
结论:我们的系统评价强调骨折后干预中需要标准化报告指南。此外,在健康结果分析中考虑公平分层将有助于解决不公平现象,并提高二级骨折预防计划的整体质量和覆盖范围。
OBJECTIVE: This systematic
review seeks to evaluate the proportion of fragility fracture patients screened in secondary fracture prevention programs who were indicated for pharmacological treatment, received prescriptions for bone-active medications, and initiated the prescribed medication. Additionally, the study aims to analyze equity in pharmacological treatment by examining equity-related variables including age, sex, gender, race, education, income, and geographic location.
METHODS: We conducted a systematic
review to ascertain the proportion of fragility fracture patients indicated for treatment who received prescriptions and/or initiated bone-active medication through secondary fracture prevention programs. We also examined treatment indications reported in studies and eligibility criteria to confirm patients who were eligible for treatment. To compute the pooled proportions for medication prescription and initiation, we carried out a single group proportional meta-analysis. We also extracted the proportions of patients who received a prescription and/or began treatment based on age, sex, race, education, socioeconomic status, location, and chronic conditions.
RESULTS: This
review included 122 studies covering 114 programs. The pooled prescription rate was 77%, and the estimated medication initiation rate was 71%. Subgroup analysis revealed no significant difference in treatment initiation between the Fracture Liaison Service and other programs. Across all studies, age, sex, and socioeconomic status were the only equity variables reported in relation to treatment outcomes.
CONCLUSIONS: Our systematic
review emphasizes the need for standardized reporting guidelines in post-fracture interventions. Moreover, considering equity stratifiers in the analysis of health outcomes will help address inequities and improve the overall quality and reach of secondary fracture prevention programs.