Primary screening for increased fracture risk by the FRAX® questionnaire-uptake rates in relation to invitation method

Arch Osteoporos. 2019 May 8;14(1):51. doi: 10.1007/s11657-019-0603-4.

Abstract

The aim of the study was to evaluate the feasibility and most efficient way of offering middle-aged Swedish women a primary fracture screening program via a questionnaire. Two out of five invited women returned the FRAX questionnaire and those contacted directly by mail were most prone to respond.

Purpose: Osteoporosis and its associated fractures are increasing, and this study aims to explore ways to identify women at an increased risk of fracture using the FRAX® algorithm.

Methods: Three thousand middle-aged women were invited and presented a questionnaire distributed by three different methods-by mail, at routine mammography, or internet-based.

Results: In total, 1120 (37.3%) women responded to the questionnaire and agreed to participate. The response rates for the mail, mammography, and internet-based groups were 39.1%, 35.7%, and 25.2% respectively. Women in the mammography group weighed more, were slightly older than the other women, and also had a higher BMI than women from the mail and internet-based groups. No difference was observed between the groups regarding previous fracture, family history for fracture, current smoking, glucocorticoid use, and alcohol usage. The mammography group had a higher median (interquartile range) major osteoporotic FRAX® score (10.0% (7.8-17.0)) than the mail group (9.7% (7.1-15.0); p = 0.005) and the internet-based group (8.7% (6.7-14.0); p = 0.001).

Conclusions: Two out of five early postmenopausal women returned the questionnaire and women contacted directly by mail were more prone to respond. Out of the participants, 26.6% had a 10-year fracture risk score ≥ 15% according to the FRAX® algorithm.

Keywords: FRAX; Fracture risk; Screening; Women.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms
  • Bone Density / physiology
  • Feasibility Studies
  • Female
  • Humans
  • Mammography / statistics & numerical data
  • Mass Screening / methods*
  • Middle Aged
  • Osteoporosis / diagnosis
  • Osteoporotic Fractures / prevention & control*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Postmenopause
  • Risk Assessment / methods*
  • Risk Factors
  • Surveys and Questionnaires / statistics & numerical data*
  • Sweden