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Research priorities regarding the use of bisphosphonates for osteoporosis: a UK priority setting exercise

Paskins, Zoe; Moult, Alice; Corp, Nadia; Bastounis, Anastasios; Davis, Sarah; Narayanasamy, Melanie Jay; Griffin, Jill; Gittoes, Neil; Leonardi-Bee, Jo; Langley, Tessa; Bishop, Simon; Sahota, Opinder


Anastasios Bastounis

Sarah Davis

Melanie Jay Narayanasamy

Jill Griffin

Neil Gittoes

Jo Leonardi-Bee

Tessa Langley

Simon Bishop

Opinder Sahota


Worldwide, many people who would benefit from osteoporosis drugs are not offered or receiving them, resulting in an osteoporosis care gap. Adherence with bisphosphonates is particularly low. This study aimed to identify stakeholder research priorities relating to bisphosphonate treatment regimens for prevention of osteoporotic fractures. A three-step approach based on the James Lind Alliance methodology for identification and prioritisation of research questions was used. Research uncertainties were gathered from a large programme of related research studies about bisphosphonate regimens and from recent published international clinical guidelines. Clinical and public stakeholders refined the list of uncertainties into research questions. The third step prioritised the questions using a modified nominal group technique. In total, 34 draft uncertainties were finalised into 33 research questions by stakeholders. The top 10 includes questions relating to which people should be offered intravenous bisphosphonates first line (1); optimal duration of treatment (2); the role of bone turnover markers in treatment breaks (3); support patient need for medicine optimisation (4); support primary care practitioner need regarding bisphosphonates (5); comparing zoledronate given in community vs hospital settings (6); ensuring quality standards are met (7); the long-term model of care (8); best bisphosphonate for people aged under 50 (9); and supporting patient decision-making about bisphosphonates (10). This study reports, for the first time, topics of importance to stakeholders in the research of bisphosphonate osteoporosis treatment regimens. These findings have implications for research into implementation to address the care gap and education of healthcare professionals. Using James Lind Alliance methodology, this study reports prioritised topics of importance to stakeholders in the research of bisphosphonate treatment in osteoporosis. The priorities address how to better implement guidelines to address the care gap, understanding patient factors influencing treatment selection and effectiveness, and how to optimise long-term care. [Abstract copyright: © 2023. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.]


Paskins, Z., Moult, A., Corp, N., Bastounis, A., Davis, S., Narayanasamy, M. J., …Sahota, O. (2023). Research priorities regarding the use of bisphosphonates for osteoporosis: a UK priority setting exercise. Osteoporosis International, 10.1007/s00198-023-06806-7.

Journal Article Type Article
Acceptance Date May 23, 2023
Online Publication Date Jun 9, 2023
Publication Date Jun 9, 2023
Deposit Date Jun 12, 2023
Publicly Available Date Jun 10, 2024
Journal Osteoporosis International
Print ISSN 0937-941X
Electronic ISSN 1433-2965
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Pages 10.1007/s00198-023-06806-7
Keywords Research priorities, Bisphosphonates, Stakeholder, Osteoporosis
Additional Information Received: 9 August 2022; Accepted: 23 May 2023; First Online: 9 June 2023; : ; : ZP reports paid non-promotional consultancy for UCB. AM, NC,AB, MN, JG, NG, JLB, TL, SB, and OS declare that they have no conflicts of interest. SD reports a grant from Roche Diagnostics to her employing institution to fund research into the cost-effectiveness of using a biomarker to monitor response to treatment with antifracture medication.