Women's Preferences for Prevention of Bone Loss

LIANA FRAENKEL, FLORINA CONSTANTINESCU, MAYRA OBERTO-MEDINA, and DICK R. WITTINK

ABSTRACT.

Objective. Despite the serious consequences of osteoporosis, few women use pharmacologic measures to prevent postmenopausal bone loss. We used an interactive computerized questionnaire to examine women's preferences for prevention of osteoporosis.

Methods. We administered a choice-based conjoint analysis survey (CBCA) to consecutive early postmenopausal women in a shopping center. The questionnaire was constructed to measure preferences for pharmacologic and nonpharmacologic measures to prevent postmenopausal bone loss. Women were also given the option of choosing "none," i.e., to defer or refuse all options. Utilities were calculated based on a Hierarchical Bayes model using Monte Carlo-Markov chain algorithms. We performed simulations based on women's values for specific treatment characteristics to estimate choice.

Results. A total of 212 women agreed to complete the survey (42% participation rate). Between 18% and 47% of the women surveyed (mean age 52 ± 5 yrs) were predicted to choose once-weekly medications to prevent postmenopausal bone loss, assuming treatment confers an absolute lifetime risk reduction in fractures of at least 10%.

Conclusion.In this CBCA survey, which derived preferences based on how women make tradeoffs between specific treatment characteristics, a significant percentage of women were willing to use once-weekly medications to prevent postmenopausal bone loss. (J Rheumatol 2005;32:1086-92)

Key Indexing Terms:

OSTEOPOROSIS
POSTMENOPAUSAL
PATIENT ACCEPTANCE OF HEALTHCARE
DIPHOSPHONATES

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From the Section of Rheumatology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut; VA Connecticut Healthcare System, West Haven, Connecticut; Washington Hospital Center, Washington, DC; and the University of Arizona.

Dr. Fraenkel was supported by a VA Career Development Award and an Arthritis Foundation Clinical Science Grant.

L. Fraenkel, MD, MPH, Department of Medicine, Yale University, VA Connecticut Healthcare System; F. Constantinescu, MD, Washington Hospital Center; M. Oberto-Medina, DO, University of Arizona; D.R. Wittink, PhD, George Rogers Clark Professor of Management and Marketing, School of Management, Yale University.

Address reprint requests to Dr. L. Fraenkel, Section of Rheumatology, Yale University School of Medicine, 300 Cedar Sreet, TAC Building, Room 525, PO Box 208031, New Haven, CT 06520-8031. E-mail: liana.fraenkel@yale.edu

Accepted for publication January 10, 2005.

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