Preference for hip protectors among older adults at high risk for osteoporotic fractures.
OBJECTIVE
To determine older adults' treatment preferences for osteoporosis comparing bisphosphonates and hip protectors.


METHODS
Subjects at high risk for an osteoporotic hip fracture completed a discrete choice questionnaire to determine preferences for hip protectors versus oral weekly bisphosphonates. Simulations, based on respondents' values for type of treatment and absolute reduction in risk of hip fractures over 5 years, were performed to predict treatment choices.


RESULTS
Seventy-six patients participated in this study (92% participation rate). At the time of the study 57% of the participants were currently using bisphosphonates; none had ever heard of a hip protector. In the base-case scenario, in which both options were described as being equally effective, 9% preferred hip protectors, 88% weekly oral bisphosphonates, and 3% refused all options. When hip protectors were described as being more effective than bisphosphonates, 26% preferred hip protectors, 71% weekly oral bisphosphonates, and 3% continued to refuse all options. Preference for hip protectors was stronger among participants not currently using bisphosphonates (36% vs 19%, p = 0.08), as well as among subjects preferring to avoid taking prescription drugs for most health problems (44% vs 12%, p = 0.002).


CONCLUSIONS
When presented with tradeoffs between hip protectors and bisphosphonates, the majority of community-dwelling older adults at high risk for fracture prefer the latter. Of note, however, many of the participants in this study were current bisphosphonate users. Future trials and education programs should consider targeting respondents preferring to manage health problems using nonpharmacologic treatment approaches since, based on the results of this study, adherence and proper use of hip protectors is expected to be higher among these patients.
Fraenkel
Liana
L
Veterans Administration Connecticut Healthcare System and the Yale University School of Medicine, New Haven, Connecticut 06520-8031, USA.
Gulanski
Barbara
B
Wittink
Dick R
DR
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006620:Hip Fractures / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications* / Q000188:drug therapy; D010349:Patient Compliance; D010353:Patient Education as Topic; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011482:Protective Devices / Q000706:statistics & numerical data*; D012307:Risk Factors; D011795:Surveys and Questionnaires
D004164:Diphosphonates