The association of osteoporosis knowledge and beliefs with preventive behaviors in postmenopausal breast cancer survivors

Knowledge of osteoporosis prevention among people with endocrine disorders: A cross-sectional study

People with endocrine disorders are at an increased risk of osteoporosis, yet their knowledge of osteoporosis prevention is rarely studied. This study aimed to assess the knowledge related to osteoporosis prevention and its associated factors among people with endocrine disorders in China. A cross-sectional study was conducted in a Chinese hospital's Department of Metabolism and Endocrinology. A total of 562 people with endocrine disorders completed the Chinese version of the Osteoporosis Prevention and Awareness Tool to assess their knowledge of osteoporosis prevention. Results showed that participants had a mean knowledge of 59.36 ± 23.90 out of 100, with only 52.1% scoring above 60 points. Being female, having higher education, with comorbidities, with a recent osteoporosis diagnosis, and having received health education related to osteoporosis prevention were associated with higher knowledge of osteoporosis prevention. Our study indicates that more efforts are needed to improve the knowledge related to osteoporosis prevention among people with endocrine disorders. This may be realized by strengthening and expanding diverse education, focusing on males and those with lower education and without comorbidities.

Osteoporosis and vitamin D consumption: knowledge and practice in different Arab countries

Despite the high prevalence of osteoporosis and vitamin D deficiency, the knowledge about osteoporosis and vitamin D-related practices were moderate in some countries in the Middle East and North Africa (MENA) region. Improving knowledge through awareness campaign and screening programs is essential to enhance vitamin D-related practices.

PURPOSE

Osteoporosis is the most common skeletal disease, which usually remains silent until fractures occur. Vitamin D deficiency impairs bone mineralization and increases the risk of osteoporosis. Despite being relatively sunny, the Middle East and North Africa (MENA) region has a high prevalence of osteoporosis and hypovitaminosis D. This study aims to assess the knowledge about osteoporosis and vitamin D-related practices and to determine the correlation between them in some countries of the MENA region.

METHODS

A cross-sectional study was performed in Lebanon, Syria, Egypt, Palestine, Iraq, Jordan, and Saudi Arabia. From each country, 600 participants were enrolled. The survey included four sections: sociodemographic information, past medical history, Osteoporosis Knowledge Assessment Tool to assess the knowledge about osteoporosis, and Practice Towards Vitamin D scale to assess vitamin D-related practices.

RESULTS

Our study found that 67.14% of respondents had moderate knowledge about osteoporosis and 42.31% had moderate vitamin D-related practices. Higher knowledge level was reported in the young, females, Syrians, singles, postgraduates, and healthcare employees (p < 0.05). Better vitamin D-related practices were detected in the elderly, males, Egyptians, married, and high school or below educational level (p < 0.05). The Internet was the most listed source of information. Adequate osteoporosis knowledge was associated with better vitamin D-related practices (p < 0.001).

CONCLUSION

Most participants, representing some countries of the MENA region, displayed moderate knowledge regarding osteoporosis and moderate vitamin D-related practices. Adequate knowledge about osteoporosis is essential to improve practices, so awareness campaigns and screening programs should be more frequently implemented.

The impact of bone mineral density screening on incident fractures and healthcare resource utilization among postmenopausal breast cancer survivors treated with aromatase inhibitors

Bone mineral density screening prior to initiating aromatase inhibitor therapy was associated with lower incident bone fractures and healthcare resource utilization among postmenopausal breast cancer survivors.

INTRODUCTION

Postmenopausal women with hormone receptor-positive breast cancer (BC) often receive aromatase inhibitor (AI) therapy. However, AIs induce bone loss and BC survivors are at an increased risk of bone fractures. This study determined whether receipt of baseline dual-energy x-ray absorptiometry (DXA) screening is associated with decreased incident fractures and lower healthcare resource utilization.

METHODS

We retrospectively analyzed 22,713 stage 0-III primary BC survivors who received AI therapy ≤ 1 year prior to BC diagnosis from the Medicare-Linked Surveillance, Epidemiology, and End-Results database. We categorized DXA screening for those who had a procedural claim within 12 months prior through 6 months after first AI claim. We used propensity score methods to assess the association of DXA screening with bone fractures and health resource utilization.

RESULTS

Of the study cohort, 62% received a DXA screening. Women with comorbid dementia, renal disease, and congestive heart failure were less likely to receive a DXA. After adjusting for confounders, BC survivors who received a DXA had a 32% decreased risk of any bone fracture compared to those who did not (hazard ratio (HR): 0.68, 95% confidence interval (CI): 0.60-0.76, p < 0.001). Similarly, those who received a DXA were less likely to be hospitalized (HR 0.73 (0.62-0.86)) or use outpatient services (HR 0.85 (0.74-0.97)).

CONCLUSIONS

Bone density screening is associated with decreased incident bone fractures and a lower likelihood of utilizing healthcare resource for fracture-related events. Postmenopausal BC survivors treated with AIs should undergo appropriate bone density screening to reduce morbidity, mortality, and health care expenses.

Knowledge and understanding risk factors and preventive measures for osteoporosis in women: results of a survey in 502 women with and without a migration background

BACKGROUND

Osteoporosis is a disease of the skeletal system associated with loss of bone mass and an increased risk of fractures affecting women more often than men. Identification of the knowledge about osteoporosis and its preventive methods is the backbone of any awareness program. This study investigates the knowledge with a special focus on women with and without a migration background.

METHODS

Data from systematic patient interviews based on a questionnaire were collected at three different sites in Berlin between February and June 2021. The survey included questions assessing migrant background, demographic characteristics, lifestyle habits including physical exercise and smoking, prevention by vitamin D intake and bone densitometry, and information on personal and family medical history. According to the responses, a scale was created to assess the level of knowledge of preventive osteoporosis measures. The ethic committee of the Charité, Medical faculty has approved this study. SPSS (version 24.0) was used for the statistical analyses.

RESULTS

The survey of 502 female patients revealed that 25% had low and 34% no previous knowledge of osteoporosis. Older age and a better education level correlate with a higher knowledge. Patients with gynecologic cancer are less well informed. There is a significant difference in vitamin D intake between migrant and non-migrant women (57% vs. 49%). There were no significant differences regarding the use of bone densitometry.

CONCLUSION

Knowledge of osteoporosis and the possibility of a bone densitometry as well as the implementation of preventive measures is low among women. Therefore, informing patients better should be a priority, with particular attention on the risks and needs of women with a migration background. Specific programs for women with and without migration background should be developed to increase the awareness of osteoporosis.

Longitudinal Assessment of Physical Activity, Fitness, Body Composition, Immunological Biomarkers, and Psychological Parameters During the First Year After Diagnosis in Women With Non-Metastatic Breast Cancer: The BEGYN Study Protocol

Background

Moderate physical activity is associated with an improved prognosis and psychosocial outcome in breast cancer patients. Although exercise and physical activity are associated with multiple physiological and psychological effects, many of the underlying mechanisms remain obscure. The BEGYN study (Influence of physical activity in breast cancer patients on physiological and psychological parameters and on biomarkers) aims at identifying potential associations between the extent of physical activity, fitness, body composition, immunological biomarkers, psycho-emotional parameters, and the course of treatment during the first year after diagnosis of breast cancer.

Methods

The prospective observational BEGYN study will include 110 non-metastatic breast cancer patients. The patients will be assessed during a base line visit prior to the initiation of the antineoplastic therapy and after 3, 6, 9 and 12 months. The physical activity will be measured using a fitness tracker and a self-assessment diary during the entire study. Each visit will include the assessment of (i) cardiorespiratory fitness measured by spiroergometry, (ii) body composition, (iii) psycho-emotional parameters (quality of life, mental health, fatigue, depression, distress, anxiety, well-being), and (iv) extensive blood tests including routine laboratory, vitamin D, selenium and immunologically relevant biomarkers (e.g., leukocyte subpopulations and cytokine profiles).

Discussion

Whereas most studies investigating the influence of physical activity in breast cancer patients focus on specific activities for three months or less, the BEGYN study will quantify the daily physical activity and cardiorespiratory fitness of breast cancer patients based on objective measurements in the context of the oncological therapy for 12 months after diagnosis. The study will reveal potential associations between exercise, immune status and physical as well as psycho-emotional outcome and the clinical course of the disease. Moreover, complementary therapies such as Vit D and Selenium supplementation and parameters investigating the motivation of the patients are part of the study. Due to this holistic approach, the BEGYN study will guide towards confirmatory studies on the role of physical activity in breast cancer patients to develop individualized counselling regarding the recommended type and extent of exercise.

Trial Registration

This study has been registered at the German Clinical Trials Register DRKS00024829.