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Hadji P, Esterberg E, Obermüller D, Bartsch R. Bone evaluation study-2: update on the epidemiology of osteoporosis in Germany. Arch Osteoporos 2024; 19:26. [PMID: 38592546 PMCID: PMC11003882 DOI: 10.1007/s11657-024-01380-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/14/2024] [Indexed: 04/10/2024]
Abstract
Osteoporosis is the most common bone disorder. Our data gives an estimate of around 5.87 million cases of osteoporosis in the general German population in 2018. Only 30% of insured individuals who suffered an osteoporotic fracture and/or had a confirmed diagnosis of osteoporosis, received an appropriate prescription. PURPOSE Osteoporosis is the most common bone disorder. It particularly affects elderly people and increases the risk of atraumatic fractures. The aim of this study was to estimate the prevalence of osteoporosis in the general German population aged ≥ 50 years and to collect data on the frequency of prescription of osteoporosis-specific medication in order to assess the treatment gap. METHODS Retrospective analysis of anonymized data of individuals aged ≥ 50 years insured under statutory healthcare schemes from the database of the Institute for Applied Health Research Berlin (InGef) for 2018 (study population). Insured individuals with osteoporosis were identified based on osteoporosis diagnoses, osteoporosis-specific prescriptions, or osteoporotic fractures. Thus, we estimated the prevalence of osteoporosis in the general German population aged ≥ 50 years. The prevalence of diagnoses, fractures, and prescriptions was determined for the study population and stratified by age and gender. RESULTS Within the study population of 1,599,299 insured individuals, a prevalence of osteoporosis of 15.9% was determined. This estimated approximately 5.87 million cases of osteoporosis for the general German population. 81.6% of the cases were women. Osteoporosis-specific prescriptions were received by 30.0% of the insured individuals in the study population who had been diagnosed with osteoporosis and/or suffered an osteoporotic fracture. CONCLUSIONS Germany has a high prevalence of osteoporosis. Only a small portion of individuals who may require osteoporosis-specific treatment actually receive it.
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Affiliation(s)
- Peyman Hadji
- Frankfurter Hormon- Und Osteoporosezentrum, Frankfurt Am Main, Germany
- Philipps-Universität Marburg, Marburg, Germany
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Wang Y, Li C, Chang R, Qiao Y, Cai Y, Shen T. Predicting osteoporosis preventive behaviors in middle-aged and older urban Shanghai residents: a health belief model-based path analysis in a multi-center population study. Front Public Health 2023; 11:1235251. [PMID: 37829086 PMCID: PMC10565685 DOI: 10.3389/fpubh.2023.1235251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023] Open
Abstract
Background Osteoporosis represents a significant health concern as a widespread metabolic bone condition. In this study, we aim to utilize path analysis to examine the intricate relationships among demographic information, Health Belief Model (HBM) constructs and osteoporosis preventive behavior among Shanghai residents over 40 years of age. Methods A multi-center population study was conducted in 20 volunteer communities in Shanghai, China. Out of the 2,000 participants who volunteered, 1,903 completed the field survey. Results 56.0% of participants were females. Their mean age was 63.64 ± 10.30 years. The self-efficacy score among females (42.27 ± 15.82) was also significantly higher than that among males (40.68 ± 15.20). in the pathway analysis. In the path analysis preventive behaviors were significantly predicted by education (β = 0.082, p < 0.001), knowledge (β = 0.132, p < 0.001) and self-efficacy (β = 0.392, p < 0.001). Conclusions This study highlights the importance of gender, education, knowledge and self-efficacy in promoting OP preventive behaviors using the Health Belief Model. The findings emphasize the need for tailored interventions to address the specific needs of different demographic groups.
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Affiliation(s)
- Yichen Wang
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Public Health, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Chenrui Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Ruijie Chang
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yongxia Qiao
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yong Cai
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Tian Shen
- Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
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Ercan S, İnce Parpucu T, Başkurt Z, Başkurt F. Health belief model - male osteoporosis: a cross-sectional study. Cent Eur J Public Health 2023; 31:184-190. [PMID: 37934477 DOI: 10.21101/cejph.a7789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/19/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES The aim of this study is to examine the knowledge levels, beliefs, and self-efficacies of men regarding osteoporosis according to the health belief model. METHODS Men aged 55 years and older were included in the study. After the descriptive characteristics of the participants were recorded, the Male Osteoporosis Knowledge Quiz, Osteoporosis Health Belief Scale, Osteoporosis Self-Efficacy Scale, and Osteoporosis Knowledge Test were administered to the participants face-to-face. RESULTS A total of 435 men with an average age of 67.3 ± 0.4 years participated in the study. When the participants were categorized according to age subgroups, it was found that marital status (p = 0.002), economic status (p = 0.016), and education level (p < 0.001) differed with age. The results of the osteoporosis-specific measurement tools used in data collection also differed with age (p < 0.05). It was observed that men's levels of osteoporosis knowledge decreased with increasing age (p < 0.05). The lowest scores for the exercise benefits and health motivation subdimensions of the Osteoporosis Health Belief Scale and the Osteoporosis Self-Efficacy Scale were obtained from the subgroup that included the oldest participants (p < 0.05). The highest scores for the calcium barriers subdimension of the Osteoporosis Health Belief Scale were obtained from younger participants (p = 0.036). The level of osteoporosis knowledge showed a low-to-moderate correlation with each question of the Osteoporosis Health Belief Scale (p < 0.05). Age, education, associating the role of physiotherapy with primary-secondary treatment approaches, and health beliefs were the factors that affected the osteoporosis knowledge levels of the participating men (p < 0.05). CONCLUSIONS The knowledge of osteoporosis and preventive beliefs and behaviours of men need to be increased. Knowledge and perceptions of susceptibility to osteoporosis should be developed in men with appropriate education from an early age. We recommend that exercise and physiotherapy approaches should be utilized to a greater extent, especially for individuals in the at-risk age range.
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Affiliation(s)
- Sabriye Ercan
- Department of Sports Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Tuba İnce Parpucu
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Suleyman Demirel University, Isparta, Turkey
| | - Zeliha Başkurt
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Suleyman Demirel University, Isparta, Turkey
| | - Ferdi Başkurt
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Suleyman Demirel University, Isparta, Turkey
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Hoit G, Whelan DB, Atrey A, Ravi B, Ryan G, Bogoch E, Davis AM, Khoshbin A. Association of age, sex and race with prescription of anti-osteoporosis medications following low-energy hip fracture in a retrospective registry cohort. PLoS One 2022; 17:e0278368. [PMID: 36454910 PMCID: PMC9714945 DOI: 10.1371/journal.pone.0278368] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Initiation of anti-osteoporosis medications after hip fracture lowers the risk of subsequent fragility fractures. Historical biases of targeting secondary fracture prevention towards certain groups may result in treatment disparities. We examined associations of patient age, sex and race with anti-osteoporosis medication prescription following hip fracture. METHODS A cohort of patients with a hip fracture between 2016-2018 was assembled from the American College of Surgeons National Surgical Quality Improvement Program registry. Patients on anti-osteoporosis medications prior to admission were excluded. Multivariable logistic regression was used to determine adjusted associations between patient age, sex and race and their interactions with prescription of anti-osteoporosis medications within 30 days of surgery. RESULTS In total, 12,249 patients with a hip fracture were identified with a median age of 82 years (IQR: 73-87), and 67% were female (n = 8,218). Thirty days postoperatively, 26% (n = 3146) of patients had been prescribed anti-osteoporosis medication. A significant interaction between age and sex with medication prescription was observed (p = 0.04). Male patients in their 50s (OR:0.75, 95%CI:0.60-0.92), 60s (OR:0.81, 95%CI:0.70-0.94) and 70s (OR:0.89, 95%CI:0.81-0.97) were less likely to be prescribed anti-osteoporosis medication compared to female patients of the same age. Patients who belonged to minority racial groups were not less likely to receive anti-osteoporosis medications than patients of white race. INTERPRETATION Only 26% of patients were prescribed anti-osteoporosis medications following hip fracture, despite consensus guidelines urging early initiation of secondary prevention treatments. Given that prescription varied by age and sex, strategies to prevent disparities in secondary fracture prevention are warranted.
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Affiliation(s)
- Graeme Hoit
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
| | - Daniel B. Whelan
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Orthopaedic Surgery, Unity Health – St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Amit Atrey
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Orthopaedic Surgery, Unity Health – St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Bheeshma Ravi
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Gareth Ryan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Earl Bogoch
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Orthopaedic Surgery, Unity Health – St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Aileen M. Davis
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Amir Khoshbin
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Orthopaedic Surgery, Unity Health – St. Michael’s Hospital, Toronto, Ontario, Canada
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Lo SST, Kok WM. Osteoporosis knowledge, health beliefs, and self-efficacy in Hong Kong Chinese men. Arch Osteoporos 2022; 17:60. [PMID: 35396655 DOI: 10.1007/s11657-022-01104-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/29/2022] [Indexed: 02/03/2023]
Abstract
A total of 277 Hong Kong Chinese men participated in this prospective cohort study. Their osteoporosis knowledge was average. Their perceived susceptibility to osteoporosis was low. Barriers to lifestyle modifications were the strongest predictor for self-efficacy in adopting these activities. These results are useful for planning osteoporosis public awareness campaigns for men. PURPOSE Male osteoporosis had long been neglected despite one-third of fractures occurring in men. Lifestyle modification through education is the main tactic in osteoporosis prevention, but current programs and strategies are designed for postmenopausal women. Understanding men's knowledge, health belief, and self-efficacy in adopting osteoporosis prevention strategies can help to design a specific program for men. METHODS A prospective cohort study was conducted in three men's health clinics in Hong Kong from September to October 2020, recruiting 277 men aged ≥ 20 years. They completed a questionnaire consisting of sociodemographic data, 14 general questions from the Facts on Osteoporosis Quiz (FOOQ), Male Osteoporosis Knowledge Quiz (MOKQ), Osteoporosis Health Belief Scale (OHBS), and Osteoporosis Self-Efficacy Scale (OSES). Scores from these scales and their association with sociodemographic data were reported. Correlations between age, knowledge, health beliefs, and self-efficacy were studied using the Health Belief Model. RESULTS The mean age was 36.4 years old, and 52% had university education. Their mean FOOQ + MOKQ score was 10.8 out of 20; mean OHBS score was 129.2 out of 210; and mean OSE-Exercise and OSE-Calcium scores were 66.4 and 68.9 out of 100 respectively. Self-efficacy of exercise was correlated with young age, perceived exercise benefits, and little barriers to exercise (p < 0.01). Self-efficacy of calcium intake was positively correlated with health motivation and self-efficacy of exercise and negatively correlated with barriers to calcium intake (p < 0.01). CONCLUSION Male osteoporosis awareness programs should focus on improving knowledge, enhancing awareness on susceptibility, promoting benefits of lifestyle modification, and helping men overcome perceived barriers.
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Affiliation(s)
- Sue Seen Tsing Lo
- The Family Planning Association of Hong Kong, 10/F Southorn Centre, 130 Hennessy Road, Wan Chai, Hong Kong SAR, China.
| | - Wai Ming Kok
- The Family Planning Association of Hong Kong, 10/F Southorn Centre, 130 Hennessy Road, Wan Chai, Hong Kong SAR, China
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