Despite the high prevalence, morbidity, and treatment costs for osteoporosis-related fractures, studies have shown that patients infrequently receive the recommended treatment for low bone density (LBD). This study investigated patient perceptions about evaluation, management, and willingness to pursue osteoporosis treatment to further elucidate potential barriers to LBD treatment.
A survey was prospectively administered to patients over 50 years old addressing patient history of fragility fractures and osteoporosis evaluation and treatment, medication administration preferences, and willingness to start a new medication to treat or prevent future fragility fractures.
Three hundred twenty-five patients completed surveys (63.1% women, 36.9% men; mean age, 64.1 years). Patients reported the following: 50.8% had taken supplements or medication for LBD. Patients who had never taken LBD prescription medications were asked about their willingness to take these medications if physician-recommended. The mean response on a 0 to 10 scale was 7.3 ± 3.2, which was not significantly different between fracture or bone density subgroups. Several barriers to taking LBD medications were identified: 85.7% said no medical provider had prescribed them; 14.0% stated they already took too many medications; 10.4% were afraid of potential side effects; 4.3% had conflicting provider recommendations; and 1.8% cited financial concerns.
Patients held a favorable opinion on taking LBD medications when prescribed. Although 29.8% of patients had an abnormal dual-energy x-ray absorptiometry (DEXA) result, 85.7% of all patients reported that no medical provider had prescribed LBD medications. A sizeable gap remains between current practice and optimal osteoporosis education and management.
Despite the large reported and increasing prevalence of osteoporosis in patients with upper extremity fragility fractures, the rate of treatment for LBD remains suboptimal.
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- Low prevalence of osteoporosis treatment in patients with recurrent major osteoporotic fracture.Arch Osteoporos. 2017; 12: 24
- The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine.J Bone Miner Res. 2014; 29: 2520-2526
- Trends in osteoporosis and low bone mass in older US adults, 2005–2006 through 2013–2014.Osteoporosis Int. 2017; 28: 1979-1988
- An overview and management of osteoporosis.Eur J Rheumatol. 2017; 4: 46-56
- Fracture risk following an osteoporotic fracture.Osteoporos Int. 2004; 15: 175-179
- Imminent fracture risk.Osteoporos Int. 2017; 28: 1765-1769
- Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women.JAMA. 2009; 301: 513-521
- Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025.J Bone Miner Res. 2007; 22: 465-475
- Randomised trial assessing the impact of framing of fracture risk and osteoporosis treatment benefits in patients undergoing bone densitometry.BMJ Open. 2017; 7e013703
- Osteoporosis medication use after hip fractures in patients between 2002 and 2011.J Bone Miner Res. 2014; 29: 1929-1937
- Medication adherence and fracture risk among patients on bisphosphonate therapy in a large United States health plan.Bone. 2012; 50: 870-875
- Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis.Mayo Clin Proc. 2007; 82: 1493-1501
- WHO Scientific Group on the Assessment of Osteoporosis at Primary Health Care Level. Summary Meeting Report.WHO, Geneva2007: 7-9
- Clinician's Guide to Prevention and Treatment of Osteoporosis.National Osteoporosis Foundation, Washington, DC2014
- The role of the orthopaedic surgeon in minimizing mortality and morbidity associated with fragility fractures.J Am Acad Orthop Surg. 2010; 18: 278-285
- Osteoporosis disease management: the role of the orthopaedic surgeon.J Bone Joint Surg Am. 2008; 90: 188-194
- A guide to improving the care of patients with fragility fractures.Geriatr Orthop Surg Rehabil. 2011; 2: 5-37
- A systematic review of persistence and compliance with bisphosphonates for osteoporosis.Osteoporosis Int. 2007; 18: 1023-1031
- Massachusetts State Health Assessment. Chap. 1: Population characteristics.Massachusetts Department of Public Health, BostonOctober 2017: 24-40
Published online: March 22, 2019
Accepted: January 25, 2019
Received: December 7, 2018
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
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