English Español English Survey: Assessment of needs regarding Adult Health for OI The Care4BrittleBones Foundation is working with international experts in OI to develop basic recommendations to improve the wellbeing of adults (individuals aged 16 years and older) living with OI.The Project team consists of Prof. Kassim Javaid, Oxford, UK Dr. Laura Tosi, Washington, USA Dr. Angela Cheung, Toronto, Canada Prof. Chapurlat and Dr. Alexandre Mercier, Lyon, France Dr. Anne Marieke Dommisse, Isala, the Netherland The project team will involve a wider network of ca. 30 professionals interested in Adult Health for OI. The project is administered by the Care4BrittleBones Foundation.To help the project team, we have developed this survey to better understand how OI is currently managed in your country from your and your family’s perspectives. Because there are so many ways OI can affect an adults life, the survey is quite long and will take around 30 minutes to complete but your answers will be very important to help develop international recommendations to improve the care of adults with OI around the world. The focus is on countries with no or very limited infrastructure for Adults with OI. Know that you can stop in between and continue updating the survey later, if you are using the exact same digital device (eg your laptop).We very much appreciate the time you take to complete the survey.This survey is anonymous and we do not collect any personal information unless you choose to leave your email address. Your responses will be stored and used by the project team to help develop basic recommendations to support people with osteogenesis imperfecta.If you choose to provide your email, it will only be used to send you the results of the survey and the outcome of the project. Your email will not be shared with anyone else and will be stored securely by Care4BrittleBones.If you know of other adults with OI, please do pass on the survey to them to complete as well.Thank you again for completing this survey before 31 January 2026.Many thanks!The Adult Health 4 OI Project team A) Tell us a little bit about yourself Question Title * 1. How old are you? (you have to be over 16 to complete this questionnaire). Question Title * 2. What is your experience of OI I have OI I provide care for a child with OI I provide care for an adult with OI I have OI and care for a child or adult with OI Question Title * 3. Which country do you live in? Argentina Bangladesh Brazil Burkina Faso Burundi Chile China Colombia Ecuador Egypt Ghana Guatemala Guyana Honduras India Indonesia Iran, Islamic Republic Of Iraq Kenya Malaysia Mali Mexico Mongolia Nepal Nicaragua Nigeria Oman Pakistan Palestinian Territory, Occupied Peru Philippines South Africa Uganda Uruguay Venezuela Zambia Zimbabwe Other Country (please specify) Question Title * 4. Which part of the country do you live in (not where you may work) Big city (> 500,000 inhabitants) Small or medium size City Far away from a city (Rural area / Province) Question Title * 5. What is your sex assigned at birth? Female Male Prefer not to say Other Question Title * 6. What is your current gender identity? Male Female Non-binary Prefer not to say Prefer to self describe – open text box Question Title * 7. Select the option that best describes your OI? Mild OI Moderate OI Severe OI Question Title * 8. Has your doctor diagnosed you with a specific type of OI? Type 1 Type 2 Type 3 Type 4 Type 5 Type 6 Type unknown I am not sure I have a diagnosis, but I don’t know the exact type of OI. Type other Question Title * 9. How tall are you now? In meters In feet and inches Indicate your height in the measure selected Question Title * 10. What is your family situation (select all that apply)? Single - living independently Single - living in care facility Married/ Long term relationship Living with children Living with parents Other (please specify) Question Title * 11. What type of healthcare do you access (select all that apply): Public/ government healthcare Private healthcare No healthcare B) Situation Today in your country B1) Getting a diagnosis of OI We want to understand how OI is being diagnosed in your country. Question Title * 12. Are there specialists or centers experienced with OI diagnosis? (select all that apply) No Yes nationally Yes regionally Don’t Know Question Title * 13. How was your OI diagnosed in your country (select all that apply): My OI has not been diagnosed by a medical team By your local healthcare team By an expert centre Using genetic testing (douplication with next question) By a geneticist in public or private hospitals Diagnosed as child - don't know how Don't know Question Title * 14. Some patients are diagnosed using genetic tests, where you offered a genetic test? No Yes Question Title * 15. If no why not Not available Cost Not offered Did not know about genetic testing. Question Title * 16. Do you think your usual local healthcare team have enough knowledge about OI ( 0 = no confidence, 10 = high confidence) 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Question Title * 17. Why is it important to have a diagnosis of OI in your country? Question Title * 18. What challenges do people with OI in your country face in getting a diagnosis of OI (select all that apply) Cost Distance Waiting times Lack of healthcare providers who know about OI Test not available Other B2) How your OI is looked after in your country after a fracture diagnosis. We want to better understand how OI is cared for by your local healthcare system so we can see where the strengths are and where the gaps are. To do this we are going to ask about your last broken bone and what happened.B2a) Diagnosing the broken bone.This section is about how your last broken bone was diagnosed. Can you tell us about the last ‘big’ bone you have broken. Question Title * 19. Which part of the body was it: Upper Arm Lower arm/ wrist Hip Thigh bone Lower leg Pelvis Spine Rib Skull Other Question Title * 20. How old were you when this happened? Question Title * 21. Where were you first treated? I did not seek medical treatment Local doctor Local hospital Regional hospital National centre Any other un-licensed practitioner with no proper know-how about OI Question Title * 22. How much did your first treating medical team know about OI? Licensed practitioners. They knew about OI Licensed practitioners. They knew a little about OI Licensed practitioners. They did not know anything about OI Licensed practitioners / National centre with a lot of knowledge about OI They were un-licensed practitioners with no proper know-how about OI They were un-licensed practitioners with know-how about OI Not applicable as I didn't seek medical treatment Question Title * 23. Did you have to educate the people you saw? (select all that apply) No A little A lot I felt they listened I felt they didn’t listen Question Title * 24. Did you need to be moved to another healthcare provider because of your fracture No, I was not moved to another hospital Yes, another local doctor Yes, a Local hospital Yes, a Regional hospital Yes, a National centre / hospital Question Title * 25. What tools or resources did you have to help you educate your local healthcare team? Question Title * 26. Who diagnosed your fracture ? Local hospital or clinic Expert hospital or clinic Other Question Title * 27. How long did it take for your fracture to be diagnosed (in hours)? B2b) Care you received after your fracture:Now we have some questions about the care you received after your fracture: Question Title * 28. Fractures are painful, how well was your pain controlled? I received good pain control from my healthcare team I sometimes received good pain control but sometimes my pain was not well controlled I routinely had pain that was not well controlled Question Title * 29. If your pain control was not good, can you describe why that was? Check all that apply... The healthcare team did not understand my OI The healthcare team did not listen to my pain severity Other reasons Question Title * 30. Did you have an operation Yes No Question Title * 31. If no, why not? Check all that apply... Doctor decision – operation not recommended My choice – I did not think I needed an operation Financial reasons There are no specialized doctors available Other reasons Question Title * 32. If you had an operation did you have A plate fitted A nail fitted Don’t know Other Question Title * 33. Did you have any physiotherapy or rehabilitation after your fracture (select all that apply)? Yes - recommended by doctor Yes – I arranged it myself No - not needed / not recommended by doctor No – but it was recommended by doctor No - Too costly No – no qualified therapist nearby No – Too long waiting time No – didn’t know about it Question Title * 34. Did you have medical treatment after your broken bone Intravenous pamidronate Intravenous zoledronate Calcium and vitamin D supplements Other treatment (please specify) No treatment at all B2c) Care outside of broken bonesWe want to better understand your experience of OI care outside of broken bones Question Title * 35. OI can affect how you walk and get around, do you have problems with walking? What aids do you sometimes or always use when outdoors None (skip to next question) Stick/ Cane Frame Wheelchair manual Wheelchair powered Stretcher/ bed Don’t go outdoors using a car using public transportation Question Title * 36. What about your access to public transport? Easy Sometimes difficult / Not all public transport is accessible. Always difficult / Not accessible at all Question Title * 37. Are people with your severity or type of OI able to drive a car in your country? Yes No – usually not possible due to cost of a car or cost to adapt the car No – legally not allowed to drive a car Question Title * 38. What challenges did you face getting your mobility assessed (select all) Not available Cost Distance Lack of available professionals to assess my mobility Waiting times Other Question Title * 39. What challenges did you face getting the mobility aid you need? (select all) Not available Cost Waiting times Other Question Title * 40. As OI affects your bone, does your healthcare team discuss calcium and vitamin D intake and use of supplements bone density testing bone medication – iv pamidronate / zoledronate/ other None of the above is discussed Question Title * 41. Which types of healthcare professionals do you routinely see for your bones Orthopedic surgeons Physiotherapists Rehabilitation Endocrinologists Rheumatologists Geneticists Other B2d) Types of routine careWe now want to know what types of care are available in your country for routine care: Question Title * 42. What assessments and treatments are available for you if you have a bone fracture and need surgery? (select all) Local hospital Regional hospital National hospital Public only Private only Mixed public and private Un-licensed practioner Professionals with limited experience Question Title * 43. What are the barriers do you have to accessing your OI expert doctor/ team? There are very few doctors (or none) They are far away It is expensive There is waiting time for routine care There is waiting time for urgent care Question Title * 44. How far is it to reach them (miles) Question Title * 45. How long does it take to travel (hours) Question Title * 46. How expensive is it? Include amount and currency Question Title * 47. How long is the waiting time for routine appointments (in months)? Question Title * 48. How long is the waiting time for urgent appointments (months)? Question Title * 49. Any other barriers? Question Title * 50. What assessments and treatments are available for you for supporting mobility, every day fitness and independent living? (select all) Local health team Local hospital Regional hospital National hospital Public only nothing is available I don't know Question Title * 51. Are there any gaps or limitations in current services for broken bones and mobility? (free text) Question Title * 52. OI can also affect other parts of the body, in the last 2 years what care have you had for your...: No care Assessment only Assessment and Treatment Dental Dental No care Dental Assessment only Dental Assessment and Treatment Hearing Hearing No care Hearing Assessment only Hearing Assessment and Treatment Heart issues Heart issues No care Heart issues Assessment only Heart issues Assessment and Treatment Breathing issues Breathing issues No care Breathing issues Assessment only Breathing issues Assessment and Treatment Stomach/ bowel issues Stomach/ bowel issues No care Stomach/ bowel issues Assessment only Stomach/ bowel issues Assessment and Treatment Pain control Pain control No care Pain control Assessment only Pain control Assessment and Treatment Tiredness Tiredness No care Tiredness Assessment only Tiredness Assessment and Treatment Anxiety / depression Anxiety / depression No care Anxiety / depression Assessment only Anxiety / depression Assessment and Treatment Question Title * 53. OI sometimes needs care from other specialists, have you been seen by these specialists for your OI yes - public yes - private no don't know Lung/ respiratory specialist Lung/ respiratory specialist yes - public Lung/ respiratory specialist yes - private Lung/ respiratory specialist no Lung/ respiratory specialist don't know Heart doctor Heart doctor yes - public Heart doctor yes - private Heart doctor no Heart doctor don't know Spine surgeon Spine surgeon yes - public Spine surgeon yes - private Spine surgeon no Spine surgeon don't know Hearing doctor Hearing doctor yes - public Hearing doctor yes - private Hearing doctor no Hearing doctor don't know Eye doctor Eye doctor yes - public Eye doctor yes - private Eye doctor no Eye doctor don't know Other doctors I have seen because of my OI… (free text) B2e) Employment and educationMany people living with rare diseases, like OI, often face financial challenges that limit their access to healthcare. That’s why it’s so important to support opportunities for education and employment—key factors in improving quality of life. Question Title * 54. Are you currently Employed Self employed Student Unemployed Retired Unable to work full time because of your OI Unable to work at all because of your OI Unable to work because of other reasons Prefer not to say Question Title * 55. Please describe what help you receive as worker or student (select all that apply) Mobility related getting to work or school Mobility / access while in work or school I don’t receive any support – even though I need it I don’t receive any support and I don’t need any support Other supports (please specify) Question Title * 56. What are the main barriers you face at school or getting or staying in work? Select all that apply... - Computers or materials are not easy to use for me - Buildings are hard to get around (no ramps, stairs, doors, toilets) - People treat me unfairly or are unkind - Teachers or bosses don’t understand what I need - I get tired or have health problems - Work or school times are not flexible for me - It’s hard to get there (transport is a problem) - Not many jobs or classes fit what I can do - I don’t have the tools or equipment I need - Hard to talk or understand others (no interpreter, unclear speech) Other (please specify) C) Infrastructure & Resources for Adult OI Health and Healthcare in your Country Question Title * 57. Which hospitals, clinics, or experts in your country are known for adult OI care? Can you name the hospitals, clinkcs or experts in your country who are known for adult OI Care? Question Title * 58. Do you know of any of these that can help with your OI care? Select all that apply... national guidelines patient organizations other support systems I don't know I don't think any of these help Other (please specify) Question Title * 59. What tools have you used to educate yourself about OI? Select all that apply... OIF Adult toolkit OIFE passport BBS adult factsheet Key4OI Formal medical educational documents in my language Anything else? Question Title * 60. Have you accessed any tools provided by other OI support groups? If none, please write "none". If yes, write which ones Question Title * 61. How helpful did you find them overall (0 not helpful – 10 very helpful) 1 = not helpful at all 10 = very helpful N/A 1 = not helpful at all 10 = very helpful N/A Question Title * 62. What else would have helped you in getting better healthcare? Question Title * 63. How well are children with OI supported when they have to move to adult services? (0 no support– 10 very supported) 1 = not supported at all 10 = very well supported 1 = not supported at all 10 = very well supported Question Title * 64. What works well for transition from child to adult care in your country? Question Title * 65. What needs improvement for transition from child to adult care in your country D) Good Service for adults with OI in your Country Question Title * 66. What do you think would be a good OI service for adults in your country. Please indicate the Healthcare Domains most important for you. Question Title * 67. Can you write down anything else you think is important for caring for adults living with OI in your country? E) Next steps for Improving health and healthcare for adults with OI in your Country Question Title * 68. For diagnosis: What should improve? Question Title * 69. For fracture management: What should be available that is not today? Question Title * 70. For mobility management: What should be available that is not today? Question Title * 71. How should mental health, lifestyle, and social wellbeing be supported? Question Title * 72. What other types of care: What services or supports are missing now but essential in the future? Question Title * 73. What role could patient organisations and healthcare systems play? Question Title * 74. What other educational resources would you like in your country for you? Question Title * 75. What other educational resources would you like in your country for your doctors? Question Title * 76. What are the next steps for improving healthcare for adults with OI? Question Title * 77. Now you have answered these questions, we want to understand what you think is most important for your country. What are the most urgent gaps to address? Select 5 and rank them in priority. (Priority 1 = highest priority.) Priority 1 Priority 2 Priority 3 Priority 4 Priority 5 Diagnosis Diagnosis Priority 1 Diagnosis Priority 2 Diagnosis Priority 3 Diagnosis Priority 4 Diagnosis Priority 5 Fracture diagnosis/ fracture care Fracture diagnosis/ fracture care Priority 1 Fracture diagnosis/ fracture care Priority 2 Fracture diagnosis/ fracture care Priority 3 Fracture diagnosis/ fracture care Priority 4 Fracture diagnosis/ fracture care Priority 5 Other Bone health & DXA Other Bone health & DXA Priority 1 Other Bone health & DXA Priority 2 Other Bone health & DXA Priority 3 Other Bone health & DXA Priority 4 Other Bone health & DXA Priority 5 Mobility & rehabilitation Mobility & rehabilitation Priority 1 Mobility & rehabilitation Priority 2 Mobility & rehabilitation Priority 3 Mobility & rehabilitation Priority 4 Mobility & rehabilitation Priority 5 Dental & hearing Dental & hearing Priority 1 Dental & hearing Priority 2 Dental & hearing Priority 3 Dental & hearing Priority 4 Dental & hearing Priority 5 Heart and lung Heart and lung Priority 1 Heart and lung Priority 2 Heart and lung Priority 3 Heart and lung Priority 4 Heart and lung Priority 5 Pain & fatigue Pain & fatigue Priority 1 Pain & fatigue Priority 2 Pain & fatigue Priority 3 Pain & fatigue Priority 4 Pain & fatigue Priority 5 Mental health Mental health Priority 1 Mental health Priority 2 Mental health Priority 3 Mental health Priority 4 Mental health Priority 5 Employment & education Employment & education Priority 1 Employment & education Priority 2 Employment & education Priority 3 Employment & education Priority 4 Employment & education Priority 5 Transition Transition Priority 1 Transition Priority 2 Transition Priority 3 Transition Priority 4 Transition Priority 5 OI Treatment for Adults OI Treatment for Adults Priority 1 OI Treatment for Adults Priority 2 OI Treatment for Adults Priority 3 OI Treatment for Adults Priority 4 OI Treatment for Adults Priority 5 Other: ___ Other: ___ Priority 1 Other: ___ Priority 2 Other: ___ Priority 3 Other: ___ Priority 4 Other: ___ Priority 5 Question Title * 78. Can you list the changes we could achieve in the next year? Question Title * 79. What resources or international collaborations could help? Check all that apply... Training - healthcare professionals Training - adults living with OI Training - families / caregivers Mobility assessment Advocacy / promotion awareness of OI Translations Clinical pathways Telehealth mentoring Equipment Advocacy Research network Setting up patient organisations Other (please specify) Question Title * 80. Is there anything else you'd like to add that we haven't covered? Question Title * 81. F) ClosingThis Questionnaire is anonymous. Optional: If you wish to be informed about this project or want to continue to be involved you can leave your contact details here. You can also participate and be kept in the loop you can also send an email to dagmar.mekking@care4brittlebones.org separately to keep your input in this survey anonymous. No need for futher information Please keep me update on any results of the survey and the project I would like to be actively involved in this project and offer my help. Question Title * 82. ONLY if you want to be updated or involved, provide your details here. Question Title * 83. ONLY if you want to be updated or involved, provide your email here Question Title * 84. ONLY if you want to be contacted also via whatsapp, provide your phone number here (including Country Code) Done