Osteoporosis Clinical Trial
Official title:
The Effectiveness of Using Mobile Device and the World Health Organization Fracture Risk Assessment Tool (FRAX®) to Assist Osteoporosis Assessment and Management
Background: The Taiwanese FRAX® (Fracture Risk Assessment Tool) calculator is available
online for clinical use. Our Taiwanese Osteoporosis Clinical Treatment Guidelines suggests
using the American high risk cut-points for considering treatment but also suggests deriving
domestic cut-points from cost-effective approach. Establishing cost-effective domestic
cut-points for policy suggestions coupled with mobile devices with wireless access would
potentially increase the usage of FRAX® tool.
Objectives: 1) Using literature review to establish cost-effectiveness FRAX® cut-points. 2)
To assess the effectiveness of mobile devices assisted FRAX® tool based osteoporosis
diagnostic and management model. 3) To provide FRAX® based reimbursement policy suggestions.
Methods: 1) Investigators will use FRAX®, cost-effectiveness and other key words to search
Pubmed and international osteoporosis guidelines to better understand the clinical
applications of FRAX® in other countries. Investigators will also search epidemiological
data for osteoporosis, facture, quality of life and cost to establish domestic
cost-effeteness, and translational approach FRAX® cut-points. 2) Three targeting populations
from National Taiwan University Hospital (NTUH) are selected for prospective study (Group A:
geriatric health exam clinics with American cut-points, group B: orthopedic clinics with
translational approach cut-points and group C: endocrine clinics with cost-effectiveness
cut-points,). A mobile device with app application coupled with the FRAX® tool is used by a
trained research assistant during clinic waiting periods to screen and enroll high risk (75
from each clinic) adults with informed consents. Participants are referred to geriatric
clinics for systemic osteoporosis diagnoses and managements. Percentage of participants that
meet the current NHI medication reimbursement regulation and percentage of self-pay
medications are calculated. Analysis is stratified by age and gender. 3) The impacts of 3
different cut-points on increment NHI reimbursement are estimated. An osteoporosis expert
group meeting is to be held for FRAX® based osteoporosis medication reimbursement
modifications to the NHI and the Department of Health.
Expected Outcomes: 1) To establish the mobile device assisted FRAX® based osteoporosis
screening and management model. 2) Base on the study results and expert consensus,
investigators will provide policy suggestions of FRAX® based reimbursement modifications.
This is an observational study. The study outcomes might base on clinical physician opnions to provide policy suggestion of FRAX® at which cut-point is considering for treatment. ;
Observational Model: Case-Only, Time Perspective: Prospective
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