Implementation and operationalization of Integrated People-Centred Health Services delivery strategies in integrated osteoporosis care (IOC) initiatives: a systematic review

Verdonck, Caroline; Willems, Ruben; Borgermans, Liesbeth

doi:10.1007/s00198-023-06678-x

Cited by 7 publications

(12 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Shared decision-making results in increased patient satisfaction, improved functional status, optimised self-management and better treatment adherence,27 but it requires comprehensive information about osteoporosis, therapeutic options and possible side effects. This information need has been reported,29 30 but its persistence is surprising, as two-thirds of this substrategy’s interventions have been operationalised in IOC 31. Furthermore, the effectiveness of different education programmes has been demonstrated 32…”

Section: Discussionmentioning

confidence: 99%

“…Strong primary care-based systems may also be able to provide more regular follow-up, which effectively improves patient compliance and persistence with therapy 42. However, the number of primary care pathways for osteoporosis management remains limited 31…”

Section: Discussionmentioning

confidence: 99%

“…This information need has been reported, 29 30 but its persistence is surprising, as two-thirds of this substrategy's interventions have been operationalised in IOC. 31 Furthermore, the effectiveness of different education programmes has been demonstrated. 32 Patients navigating the US's private healthcare system felt better informed, but expressed discontentment that their knowledge was not taken into account, which hindered strong therapeutic alliance building.…”

Section: Discussionmentioning

confidence: 99%

“…42 However, the number of primary care pathways for osteoporosis management remains limited. 31 In addition to being coordinated, fracture prevention services should cover the entire lifespan ('defining service priorities over the life course needs'). Currently, bone health is often brought up only with older patients or after fracture occurrence (if at all).…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Osteoporosis care through an Integrated, People-Centred Health Services framework lens: a hybrid qualitative analysis of international patient experiences

2023

Self Cite

View full text Add to dashboard Cite

ObjectivesGlobally, patients with osteoporosis have unmet needs in terms of care accessibility, patient-centredness and care comprehensiveness. The WHO developed the Integrated, People-Centred Health Services (IPCHS) framework to reorient and integrate healthcare systems using 5 interdependent strategies and 20 substrategies. Patients’ perspectives with regard to these strategies are poorly understood. We sought to relate patient-experienced gaps in osteoporosis care to the IPCHS strategies and identify key strategies to guide osteoporosis care reforms.Design, setting and participantsQualitative online study of the experiences of international patients with osteoporosis.ProcedureTwo researchers conducted semi-structured interviews in English, Dutch, Spanish and French that were recorded and transcribed verbatim. Patients were categorised according to their countries’ healthcare systems (universal, public/private and private) and fracture status. A hybrid (sequential theory-driven and data-driven) analysis was performed, with the IPCHS framework used for the theory-driven analysis.ResultsThirty-five patients (33 women) from 14 countries participated. Twenty-two patients had universal healthcare and 18 had experienced fragility fractures. Prioritised substrategies overlapped among healthcare systems, with reported shortcomings related primarily to ‘empowering and engaging individuals and families’ and ‘coordinating care’ (at varying levels). Patients with all healthcare types prioritised ‘reorienting care’, with different substrategies prioritised. Patients with private healthcare called for ‘improving funding and reforming payment systems’. Substrategy prioritisation did not differ between those receiving primary and secondary fracture prevention.ConclusionPatients’ experiences with osteoporosis care are universal. Given the current care gaps and associated patient burdens, policymakers should make osteoporosis a(n) (inter)national health priority. Integrated osteoporosis care reforms should focus on patient-reported experiences with and be guided by priorities in IPCHS strategies, taking into account the healthcare system context.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Osteoporosis care through an Integrated, People-Centred Health Services framework lens: a hybrid qualitative analysis of international patient experiences

2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Osteoporosis, a chronic metabolic bone disorder prevalent among the elderly, is characterized by a decline in bone mineral density (BMD) and compromised bone micro-architecture ( 1 ). A recent meta-analysis showed that the global prevalence of osteoporosis was 19.7% (95% CI: 18% to 21%) ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

The critical role of toll-like receptor 4 in bone remodeling of osteoporosis: from inflammation recognition to immunity

Zhu,

Du,

Zhang

et al. 2024

Front. Immunol.

View full text Add to dashboard Cite

Osteoporosis is a common chronic metabolic bone disorder. Recently, increasing numbers of studies have demonstrated that Toll-like receptor 4 (TLR4, a receptor located on the surface of osteoclasts and osteoblasts) plays a pivotal role in the development of osteoporosis. Herein, we performed a comprehensive review to summarize the findings from the relevant studies within this topic. Clinical data showed that TLR4 polymorphisms and aberrant TLR4 expression have been associated with the clinical significance of osteoporosis. Mechanistically, dysregulation of osteoblasts and osteoclasts induced by abnormal expression of TLR4 is the main molecular mechanism underlying the pathological processes of osteoporosis, which may be associated with the interactions between TLR4 and NF-κB pathway, proinflammatory effects, ncRNAs, and RUNX2. In vivo and in vitro studies demonstrate that many promising substances or agents (i.e., methionine, dioscin, miR-1906 mimic, artesunate, AEG-1 deletion, patchouli alcohol, and Bacteroides vulgatus) have been able to improve bone metabolism (i.e., inhibits bone resorption and promotes bone formation), which may partially attribute to the inhibition of TLR4 expression. The present review highlights the important role of TLR4 in the clinical significance and the pathogenesis of osteoporosis from the aspects of inflammation and immunity. Future therapeutic strategies targeting TLR4 may provide a new insight for osteoporosis treatment.

show abstract

Association between the ESR1 and ESR2 polymorphisms and osteoporosis risk: An updated meta-analysis

Bai,

Su,

et al. 2023

Medicine

View full text Add to dashboard Cite

Background: Gene polymorphisms of estrogen receptor (ESR) 1 PvuII (rs2234693), XbaI (rs9340799), G2014A (rs2228480), ESR2 AluI (rs4986938), and RsaI (rs1256049) had been reported to be associated with the risk of osteoporosis. However, these conclusions were inconsistent, therefore, an updated meta-analysis was conducted to further explore these issues. Objective: To evaluate the association between gene polymorphisms of ESR1 PvuII (rs2234693), XbaI (rs9340799), G2014A (rs2228480), ESR2 AluI (rs4986938), RsaI (rs1256049), and osteoporosis risk. Materials and methods: PubMed, Medline, Ovid, Embase, CNKI, and China Wanfang databases were searched. Association was assessed using odds ratio with 95% confidence interval. Moreover, the false-positive reporting probability, Bayesian false-finding probability, and Venetian criteria were used to assess the credibility of statistically significant associations. Results: Overall, ESR1 PvuII (rs2234693) and XbaI (rs9340799) were associated with the risk of osteoporosis in Indians. Moreover, ESR1 G2014A (rs2228480) was associated with the decreased risk of osteoporosis in East Asians. Moreover, ESR2 Alul (rs4986938) was associated with the increased risk of osteoporosis in East Asians and Caucasians. There was a significant association between ESR2 Rsal (rs1256049) and osteoporosis risk in overall population. When only high-quality and Hardy–Weinberg equilibrium studies were included in the sensitivity analysis, all results did not change in the present study. When the credibility was evaluated applying false-positive reporting probability, Bayesian false-finding probability, and Venetian criteria, all significant associations were considered as false positive results. Conclusions: In summary, this study shows that all substantial associations between gene polymorphisms of ESR1 (PvuII, XbaI, and G2014A) and ESR 2 (AluI and RsaI) and osteoporosis risk are possibly false positive results instead of real associations or biological variables.

show abstract

Implementation and operationalization of Integrated People-Centred Health Services delivery strategies in integrated osteoporosis care (IOC) initiatives: a systematic review

Cited by 7 publications

References 98 publications

Osteoporosis care through an Integrated, People-Centred Health Services framework lens: a hybrid qualitative analysis of international patient experiences

Osteoporosis care through an Integrated, People-Centred Health Services framework lens: a hybrid qualitative analysis of international patient experiences

The critical role of toll-like receptor 4 in bone remodeling of osteoporosis: from inflammation recognition to immunity

Association between the ESR1 and ESR2 polymorphisms and osteoporosis risk: An updated meta-analysis

Contact Info

Product

Resources

About