Understanding Patients’ Perspectives and Educational Needs by Type of Osteoporosis in Men and Women and People with Glucocorticosteroid-Induced Osteoporosis: A Qualitative Study to Improve Disease Management

Beauvais, Catherine; Poivret, Didier; Lespessailles, Éric; Thevenot, C; Aubraye, Dominique; Ziegler, L. Euller; Béranger, Martine; Filaire, Edith; Gendarme, S.; Legrand, K.; Magar, Y.; Rousière, Mickaël; Lévy-Weil, Florence; Cortet, Bernard; Rat, Anne Christine

doi:10.1007/s00223-019-00607-z

Cited by 10 publications

(9 citation statements)

References 43 publications

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“…(25,26) Recent qualitative research has identified how adherence and persistence with medication can be impacted by the confluence of patients' medication beliefs, including perceived ineffectiveness and fear of side effects, with patients' preference for "natural" treatments and lack of knowledge about the connection between osteoporosis and risk of fracture. (22,27,28) Our findings confirm findings from these other qualitative studies and suggest that people hold beliefs about bone health treatment that we can build on. Participants are concerned about sustaining their overall health; and they are used to living their lives, using their bodies, and managing the limitations of their bodies.…”

Section: Discussionsupporting

confidence: 87%

“…A recent qualitative metasynthesis ( 13 ) identified 10 studies examining patient barriers to DXA. Although most subjects were White women and thus not necessarily representative of older Veterans, the findings there suggest that patient engagement with osteoporosis care is affected by: osteoporosis's asymptomatic nature; perceived age and gender stigma associated with an osteoporosis diagnosis ( 17–22 ) ; confusion about the DXA's purpose; the belief that osteoporosis is not a serious health concern; the relatively lower ranking of osteoporosis in relation to other health conditions; and the belief that osteoporosis fractures are not indicative of disease but arise from poor luck. ( 13,23 )…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Attitudes toward bone health among rural‐dwelling veterans identified as at risk of fracture: a qualitative analysis

et al. 2021

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Although much is known about system-level barriers to prevention and treatment of bone health problems, little is known about patient-level barriers. The objective of this study was to identify factors limiting engagement in bone health care from the perspective of rural-dwelling patients with known untreated risk. Over 6 months, 39 patients completed a qualitative interview. Interview questions focused on the patient's experience of care, their decision to not accept care, as well as their knowledge of osteoporosis and the impact it has had on their lives. Participants were well-informed and could adequately describe osteoporosis and its deleterious effects, and their decision making around accepting or declining a dual-energy x-ray absorptiometry (DXA) scan and treatment was both cautious and intentional. Decisions about how to engage in treatment were tempered by expectations for quality of life. Our findings suggest that people hold beliefs about bone health treatment that we can build on. Work to improve care of this population needs to recognize that bone health providers are not adding a behavior of medication taking to patients, they are changing a behavior or belief.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Attitudes toward bone health among rural‐dwelling veterans identified as at risk of fracture: a qualitative analysis

et al. 2021

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“…Similarly, in the presented study, the quality of life of men with osteoporosis measured on the Qualleffo41 scale was significantly lower (a median of 38 pts) compared with the healthy participants (28 pts). According to Beauvais et al [ 26 ], men affected by osteoporosis are poor at coping with a loss of function. Moriyama et al and Ferrier et al observed that osteoporosis makes people pessimistic, depresses their mood, and results in sleeplessness and fatigue [ 20 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Quality of Life and Pain Severity in Older Men with Osteoporosis: Cross-Sectional Study

Nawrat–Szołtysik

Miodońska

Piejko

et al. 2021

IJERPH

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Background: The quality of life in osteoporosis is studied for men rather than for women. Aim of the study was to determine how bone mass density (BMD) relates to life quality components and the severity of pain felt by men affected by osteoporosis. Methods: Presented research is a cross-sectional study. The cohort of 62 men aged 65 to 85 years was divided into a group with osteoporosis (N = 27) and a group without osteoporosis (N = 35). The participants’ quality of life was measured with the Qualeffo41 Questionnaire, BMD was quantified by densitometry, and pain intensity was assessed on the Visual Analogue Scale. Results: We found that lower BMD was strongly correlated to participants’ quality of life (r = −0.72), especially the quality of leisure and social activities (r = −0.66), general health perception (r = −0.59), and mobility (r = −0.57). Pain significantly affected general health perception in older men with osteoporosis. General health assessment and pain were highly correlated with each other (r = 0.888). Conclusion: BMD and the overall quality of life of the study participants were related to each other. The strongest relationship occurred between reduced BMD and leisure and social activities component. The pain significantly affected participants’ general health perception. The results may be employed to create new prophylactic strategies to improve life quality in men with osteoporosis.

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“…It is important for future studies to include males and specific populations such as those with glucocorticoid-induced osteoporosis who are likely to have different experiences and needs. 51 Only two studies reported the views of managers but unfortunately neither of these studies distinguished professional roles in the presentation of results, so a further need exists to explore perceptions of this group, and perceptions of payors and academics. Finally, although the population from which each study sampled was reasonably well described, it was not always possible to appreciate if the setting was primary or secondary care; the majority of studies appeared to recruit from primary care which may explain the lack of findings related to intravenous bisphosphonates and limit the transferability of our findings to non-primary care settings.…”

Section: Discussionmentioning

confidence: 99%

Acceptability of bisphosphonates among patients, clinicians and managers: a systematic review and framework synthesis

et al. 2020

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ObjectiveTo explore the acceptability of different bisphosphonate regimens for the treatment of osteoporosis among patients, clinicians and managers, payers and academics.DesignA systematic review of primary qualitative studies. Seven databases were searched from inception to July 2019. Screening, data extraction and quality assessment of full-articles selected for inclusion were performed independently by two authors. A framework synthesis was applied to extracted data based on the theoretical framework of acceptability (TFA). The TFA includes seven domains relating to sense-making, emotions, opportunity costs, burden, perceived effectiveness, ethicality and self-efficacy. Confidence in synthesis findings was assessed.SettingAny developed country healthcare setting.ParticipantsPatients, healthcare professionals, managers, payers and academics.InterventionExperiences and views of oral and intravenous bisphosphonates.ResultsTwenty-five studies were included, mostly describing perceptions of oral bisphosphonates. We identified, with high confidence, how patients and healthcare professionals make sense (coherence) of bisphosphonates by balancing perceptions of need against concerns, how uncertainty prevails about bisphosphonate perceived effectiveness and a number of individual and service factors that have potential to increase self-efficacy in recommending and adhering to bisphosphonates. We identified, with moderate confidence, that bisphosphonate taking induces concern, but has the potential to engender reassurance, and that both side effects and special instructions for taking oral bisphosphonates can result in treatment burden. Finally, we identified with low confidence that multimorbidity plays a role in people’s perception of bisphosphonate acceptability.ConclusionBy using the lens of acceptability, our findings demonstrate with high confidence that a theoretically informed, whole-system approach is necessary to both understand and improve adherence. Clinicians and patients need supporting to understand the need for bisphosphonates, and clinicians need to clarify to patients what constitutes bisphosphonate treatment success. Further research is needed to explore perspectives of male patients and those with multimorbidity receiving bisphosphonates, and patients receiving intravenous treatment.PROSPERO registration numberCRD42019143526.

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Understanding Patients’ Perspectives and Educational Needs by Type of Osteoporosis in Men and Women and People with Glucocorticosteroid-Induced Osteoporosis: A Qualitative Study to Improve Disease Management

Cited by 10 publications

References 43 publications

Attitudes toward bone health among rural‐dwelling veterans identified as at risk of fracture: a qualitative analysis

Attitudes toward bone health among rural‐dwelling veterans identified as at risk of fracture: a qualitative analysis

Assessment of Quality of Life and Pain Severity in Older Men with Osteoporosis: Cross-Sectional Study

Acceptability of bisphosphonates among patients, clinicians and managers: a systematic review and framework synthesis

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