Abstract
Introduction: General practitioners (GPs) are key participants in osteoporosis (OP) management. The aim was to evaluate their adherence to lege artis management of the disease, potential barriers, and to discuss differences observed in comparison with the baseline survey carried out in 2007; the focus was on secondary prevention.Methods: On behalf of two professional associations, 2-round postal survey among randomly selected GPs (>1/4 of all Czech GPs) was performed in 2014. The questionnaire covered areas concerning GP's role in the fight against OP, knowledge about OP, management of OP-related fractures, barriers to the management of OP, system- and patient-related in particular, and availability and use of information sources.Results: The overall questionnaire return rate was 37% (551 respondents); mean age of the respondents was 53 year (37% men). The GP's role in the treatment of OP was rated as essential in 28 and 37% of men and women, respectively (P = 0.012). The guideline for diagnosis and treatment of OP for GPs was considered accessible by 92% of respondents. As much as 60% of the respondents were adherent to the guideline, i.e., used it repeatedly. The knowledge of several risk factors was very good, however, recommended daily intake of calcium was stated correctly by only 41% of respondents, and daily intake of vitamin D by only 40%. Three quarters reported active steps after a fracture: referral to a specialist, life-style recommendations, prescription of calcium/vitamin D supplements. Half of the respondents focus on fall prevention. System-related barriers, such as lack of possibility to prescribe selected drugs (61%) and financial limits set by health insurance company (44%) were most frequently reported. Patient-related barriers were also common, patient's non-adherence (reported by 29%) and patient's reluctance to go to a specialist (18%).Conclusion: GPs adhered to OP management more than in 2007. Knowledge of risk factors and involvement in post-fracture care was relatively high. Compared to baseline survey, patient-related barriers, patient non-adherence in particular, were more common. Prescribing conditions are still an important issue. Among GPs, education should be focused on calcium and vitamin D intake, doses, sources, and supplements.
Highlights
General practitioners (GPs) are key participants in osteoporosis (OP) management
We focused on knowledge about OP and its connection with adherence to the guideline, steps taken after a fracture, and potential barriers in management among Czech GPs
GPs adhered to the selected areas of OP management more than in 2007
Summary
General practitioners (GPs) are key participants in osteoporosis (OP) management. The aim was to evaluate their adherence to lege artis management of the disease, potential barriers, and to discuss differences observed in comparison with the baseline survey carried out in 2007; the focus was on secondary prevention. Osteoporosis (OP) is a systemic disease characterized by low bone mass and deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture (Kanis et al, 2013). When adjusting the demographic projections for 2025, the number of incident fractures was estimated at 94,000 in 2025, representing an increase of 21,000 fractures (Svedbom et al, 2013). 9,300 women and 3,500 men aged over 50 years suffer fractures of the proximal femur every year (Štepán et al, 2015). The remaining lifetime probability of hip fracture at the ages of 50 years in men and women was estimated to approximately 7 and 15%, respectively (Stepan et al, 2012)
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