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1.
Osteoporos Int ; 28(3): 833-840, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27757506

RESUMO

The recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French population aged over 60 years. INTRODUCTION: This study aims to assess the public health and economic impact of vitamin D-fortified dairy products in the general French population aged over 60 years. METHODS: We estimated the lifetime health impacts expressed in number of fractures prevented, life years gained, and quality-adjusted life years (QALY) gained of the recommended intake of dairy products in the general French population over 60 years for 1 year (2015). A validated microsimulation model was used to simulate three age cohorts for both women and men (60-69, 70-79, and >80 years). The incremental cost per QALY gained of vitamin D-fortified dairy products compared to the absence of appropriate intake was estimated in different populations, assuming the cost of two dairy products per day in base case. RESULTS: The total lifetime number of fractures decreased by 64,932 for the recommended intake of dairy products in the general population over 60 years, of which 46,472 and 18,460 occurred in women and men, respectively. In particular, 15,087 and 4413 hip fractures could be prevented in women and men. Vitamin D-fortified dairy products also resulted in 32,569 QALYs and 29,169 life years gained. The cost per QALY gained of appropriate dairy intake was estimated at €58,244 and fall below a threshold of €30,000 per QALY gained in women over 70 years and in men over 80 years. CONCLUSION: Vitamin D-fortified dairy products have the potential to substantially reduce the burden of osteoporotic fractures in France and seem an economically beneficial strategy, especially in the general population aged above 70 years.


Assuntos
Laticínios/economia , Alimentos Fortificados/economia , Fraturas por Osteoporose/prevenção & controle , Saúde Pública/economia , Vitamina D/administração & dosagem , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Feminino , França/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Osteoporose/dietoterapia , Osteoporose/epidemiologia , Fraturas por Osteoporose/economia , Fraturas por Osteoporose/epidemiologia , Saúde Pública/métodos , Anos de Vida Ajustados por Qualidade de Vida , Vitamina D/economia
2.
Osteoporos Int ; 27(1): 301-8, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26395885

RESUMO

UNLABELLED: Titrated supplementations with vitamin D-fortified yogurt, based on spontaneous calcium and vitamin D intakes, can be cost-effective in postmenopausal women with or without increased risk of osteoporotic fractures. INTRODUCTION: The objective of this study is to assess the cost-effectiveness of the vitamin D-fortified yogurt given to women with and without an increased risk of osteoporotic fracture. METHODS: A validated cost-effectiveness microsimulation Markov model of osteoporosis management was used. Three personalized supplementation scenarios to reflect the Ca/Vit D needs taking into account the well-known variations in dietary habits and a possible pharmacological supplementation in Ca/Vit D, given above or in combination with anti-osteoporosis medications: one yogurt per day, i.e., 400 mg of Ca + 200 IU of Vit D (scenario 1 U), two yogurts per day, i.e., 800 mg of Ca + 400 IU of Vit D (scenario 2 U), or three yogurts per day, i.e., 1,200 mg of Ca + 600 IU of Vit D (scenario 3 U). RESULTS: One yogurt is cost-effective in the general population above the age of 70 years and in all age groups in women with low bone mineral density (BMD) or prevalent vertebral fracture (PVF). The daily intake of two yogurts is cost-effective above 80 years in the general population and above 70 years in the two groups of women at increased risk of fractures. However, an intake of three yogurts per day is only cost-effective above 80 years old in the general population, as well as in women with low BMD or PVF. CONCLUSIONS: Our study is the first economic analysis supporting the cost-effectiveness of dairy products, fortified with vitamin D, in the armamentarium against osteoporotic fractures.


Assuntos
Laticínios/economia , Alimentos Fortificados/economia , Fraturas por Osteoporose/prevenção & controle , Vitamina D/administração & dosagem , Iogurte/economia , Idoso , Idoso de 80 Anos ou mais , Cálcio da Dieta/administração & dosagem , Análise Custo-Benefício , Feminino , Humanos , Modelos Econométricos , Osteoporose Pós-Menopausa/complicações , Osteoporose Pós-Menopausa/dietoterapia , Osteoporose Pós-Menopausa/economia , Fraturas por Osteoporose/economia , Fraturas por Osteoporose/etiologia , Anos de Vida Ajustados por Qualidade de Vida
3.
Curr Med Res Opin ; 24(10): 2841-51, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18759997

RESUMO

BACKGROUND: Hip fracture creates a worldwide morbidity, mortality and economic burden. After surgery, many patients experience long-term disability or die as a consequence of the fracture. A fracture is a major risk factor for a subsequent fracture, which may occur within a short interval. METHODS: A literature search on post-fracture management of patients with hip fracture was performed on the Medline database. Key experts convened to develop a consensus document. FINDINGS: Management of hip-fracture patients to optimize outcome after hospital discharge requires several stages of care co-ordinated by a multidisciplinary team from before admission through to discharge. Further studies that specifically assess prevention and post-fracture management of hip fracture are needed, as only one study to date has assessed an osteoporosis medication in patients with a recent hip fracture. Proper nutrition is vital to assist bone repair and prevent further falls, particularly in malnourished patients. Vitamin D, calcium and protein supplementation is associated with an increase in hip BMD and reduction in falls. Rehabilitation is essential to improve functional disabilities and survival rates. Fall prevention and functional recovery strategies should include patient education and training to improve balance and increase muscle strength and mobility. Appropriate management can prevent further fractures and it is critical that high-risk patients are identified and treated. To foster this process, clinical pathways have been established to support orthopaedic surgeons. CONCLUSION: Although hip fracture is generally associated with poor outcomes, appropriate management can ensure optimal recovery and survival, and should be prioritized after a hip fracture to avoid deterioration of health and prevent subsequent fracture.


Assuntos
Fraturas do Quadril/mortalidade , Fraturas do Quadril/reabilitação , Acidentes por Quedas/prevenção & controle , Densidade Óssea/efeitos dos fármacos , Cálcio/administração & dosagem , Proteínas Alimentares/administração & dosagem , Feminino , Humanos , Masculino , Desnutrição/mortalidade , Desnutrição/reabilitação , Monitorização Fisiológica/métodos , Estudos Prospectivos , Vitamina D/administração & dosagem
4.
Bone ; 42(2): 246-9, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18055288

RESUMO

The role of calcium and vitamin D supplementation in the treatment of osteoporosis has been extensively studied. The aim of this paper was to reach, where possible, consensus views on five key questions relating to calcium and vitamin D supplementation in the management of osteoporosis. Whereas global strategies that target supplementation to the general population could not be justified in terms of efficacy and health economics, there is a clearer rationale for supplementing patients who are at increased risk of osteoporosis and those who have developed osteoporosis, including those already taking other treatments for osteoporosis. The combination of vitamin D with calcium may be beneficial in terms of efficacy and, perhaps, for optimising adherence.


Assuntos
Cálcio/metabolismo , Cálcio/uso terapêutico , Osteoporose/dietoterapia , Vitamina D/uso terapêutico , Animais , Suplementos Nutricionais , Feminino , Humanos , Osteoporose/epidemiologia , Pós-Menopausa/efeitos dos fármacos , Vitamina D/farmacologia
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