Utility of PINP to monitor osteoporosis treatment in primary care, the POSE study (PINP and Osteoporosis in Sheffield Evaluation)

• Published in: Bone (New York, N.Y.) N.Y.), 2022-05, Vol.158, p.116347-116347, Article 116347
• Main Authors: Mattia, L., Davis, S., Mark-Wagstaff, C., Abrahamsen, B., Peel, N., Eastell, R., Schini, M.
• Format: Article
• Language: English
• Subjects: Biomarkers; Bone turnover markers; Cost-Benefit Analysis; Cost-effectiveness; Diphosphonates - therapeutic use; Humans; Monitoring treatment; Osteoporosis; Osteoporosis - diagnostic imaging; Osteoporosis - drug therapy; PINP; Primary Health Care; Retrospective Studies
• ISSN: 8756-3282; 1873-2763
• DOI: 10.1016/j.bone.2022.116347

In Sheffield (UK), we introduced the PINP monitoring algorithm for the management of osteoporosis treatment delivered in primary care. Our aims were to evaluate whether this algorithm was associated with better osteoporosis outcomes and was cost-effective compared to standard care. Inclusion criteria were referral from Sheffield GPs, BMD scans performed between 2012 and 2013 and a report advising initiation of oral bisphosphonate and PINP monitoring. 906 patients were identified and retrospectively divided into Group A (intention to monitor, with baseline PINP, n = 588) and Group B (no intention to monitor, without baseline PINP, n = 318). The model described by Davis and colleagues was used to extrapolate life-time costs and quality-adjusted life-years (QALYs). No differences were found in baseline characteristics between groups (age, gender, BMI, BMD and major risk factors for fractures). More patients in Group A started oral treatment (77.4% vs 49.1%; p 3 months or in treatment duration. Patients in Group A were more likely to have follow-up DXA scan at 4–6 years from baseline (46.9% vs 29.2%; p