Older Womenʼs Views about Prescription Osteoporosis Medication

Abstract

Older women with osteoporosis need clear information about their condition, including the diagnosis, the implications of the diagnosis, treatment options, medication effectiveness and side effects. Physicians should check with their patients to confirm understanding and address concerns, as older women may not always voice their reservations and concerns.

Patients' expectations of medicines – a review and qualitative synthesis

“…18 More general descriptions of medicines as effective tools to care for oneself beyond what can be obtained with diet and exercise are shared in interviews with patients suffering from heart failure and osteoporosis. 25,27 In terms of expressing expectations, it has been suggested that this is predominantly done by patients looking for specific outcomes, especially in relation to a condition that greatly impacts on their daily lives. Context Semi-structured interviews with 61 patients recruited from GP practices in three areas in the UK.…”

“…Confirmation of effects is sought, and lack of identifiable effects can lead to the medicine being seen as not useful 10,24,26,27 Medicines offer something beyond what is achieved by diet and exercise 25,28 A medicine prescribed for prevention 'stops a heart attack', 'cures the bones' or 'does the job the doctor says need to be done'…”

“…Experiences and evaluation develop over time Duration of illness influences understanding of disease and treatment effects 26,34 Past bad experiences of side-effects triggers a conscious evaluation of risks and benefits when new treatments are suggested 26 Patients are seeking to confirm and adjust expectations 26,28 One's own experiences and those of other people are used in decisions about medicines 24,25,28,29,[34][35][36] Risks and benefits are balanced by patients in a different way than by doctors 26,[29][30][31][32] 3. Negative values -dependency, criticism and social stigma…”

“…Medicines for different conditions are seen as being of different value 38 Patients with the same condition express diametrically different views about the treatment: necessary or of very limited value; as something that helps to live normally or the only way to avoid death; as a choice based on experience or a resignation in lack of other options 23,25,37 Core health beliefs and notions of responsibility and morality influence decisions Patients' expectations of medicines, U Dohnhammar, J Reeve and T Walley shorter time-scale when determining whether a medicine has beneficial effects. Their acceptance of risks or symptoms in relation to sideeffects and the number of aspects weighted into decisions also make patients' decision making different from that stipulated by a biomedical model of health and illness.…”

“…29,34 Aside from patients' own experiences, information from surrounding people is reported by several authors as influential on expectations. Doctors' advice 30,35 is balanced with personal and vicarious experiences, 25 whereas academics and pharmaceutical industry are seen as less reliable sources. 36 Development of trust in a prescriber seems to influence patients' decision to accept treatment, suggesting that it leads to expectations of beneficial effects, 28,36 while patients that retain a more critical stance compare prescribing to experimentation and question the doctor's knowledge about how a specific patient's body works.…”