The gaps between patient and physician understanding of the emotional and physical impact of osteoporosis

Abstract

A multinational survey was conducted to evaluate the gaps between patients and physicians understanding of osteoporosis. The International Osteoporosis Foundation recommends the creation of community-wide patient support programmes to increase prevention and treatment awareness of osteoporosis. Introduction Osteoporosis is often undiagnosed and untreated, leaving millions of people at risk of debilitating fractures. A survey was designed to investigate any gaps that may exist between physician and patient knowledge of osteoporosis, understand barriers to patient adherence and identify ways to address unmet needs and improve communications. Methods Telephone interviews were conducted with patients (n=844) and physicians (n=837) in 13 countries in June/July 2009. Patients were women with postmenopausal osteoporosis currently taking (or in the past 2 years) prescribed medication. Physicians had experience in treating osteoporotic patients, which included only general practitioners who saw ≥10 (exception: in Hungary ≥5) and specialists who saw ≥20 patients with osteoporosis per month. Results Physicians consistently underestimated their patients' adherence to treatment and beliefs on the impact of osteoporosis on their quality-of-life. Physicians underestimated how many patients worry about breaking a bone (51% vs 79%), as well as patient concerns about declines in activity levels (40% vs 70%), becoming dependent on others (30% vs 60%) and not being able to work for longer (30% vs 57%). Patients believed the most credible osteoporosis information was from specialists (94%). Patients (75%) would like easy to understand materials and 49% would welcome inter-patient discussions of their

Systematic scoping review of patients’ perceived needs of health services for osteoporosis

“…A total of 16975 patients were included; the sample size of the quantitative studies ranged from 21 to 3438, with a median of 765 and the sample size of the qualitative studies ranged from 14 to 164, with a median of 25. Across the studies, 95% of the participants were female: 22 studies examined only female participants 34,36,38,40,41,[44][45][46][47][48][49][50]52,53,58,60,61,[63][64][65][66][67] and the remaining 11 studies evaluated mainly women 35,37,39,42,43,51,[54][55][56][57]59 . The mean age of participants was 68 years.…”

“…Nineteen studies used quantitative methods 34,37,39,40,42,44,46,47,[50][51][52]58,59,61,[63][64][65][66][67] , all of which were cross sectional surveys; of these, 13 used questionnaires 37,39,42,46,47,50,51,58,61,63,65,67 , 5 used surveys 34,40,44,59,64 and 1 used interviews 52 . Fourteen used qualitative methods 35,36,38,41,43,45,48,49,[53][54][55][56][57]60 ; of these, 10 used interviews 35,36,…”

“…The inclusion criteria for study participants varied across studies. Patients were classified as having osteoporosis based on bone densitometry in seven studies 34,41,46,48,53,65 , requiring prescription medications in six studies 42,45,52,59,63,66 or on the basis of previous fragility fractures or high risk of osteoporotic fractures in eight studies [37][38][39]47,[54][55][56]61 . The diagnosis of osteoporosis or osteopenia was unspecified in 13 studies 36,40,43,44,[49][50][51]57,58,60,64,67 .…”

“…Four studies reported on the desired characteristics of medical practitioners in the management of osteoporosis 36,41,45,52 . Besser found that patients wanted to be involved with decisions related to osteoporosis treatment 36 .…”

“…Besser found that patients wanted to be involved with decisions related to osteoporosis treatment 36 . Lau and Rizzoli reported the patients wanted follow up from healthcare providers for support and monitoring of medications 45,52 . Also, patients wanted their osteoporosis to be taken seriously by their practitioners 41 and to be able to discuss medication problems and concerns 45 .…”