Abstract
BackgroundOsteoporosis prevention, diagnosis and treatment remain suboptimal.ObjectivesWe conducted a qualitative study to understand barriers towards care initiation and levers to improve awareness and management of osteoporosis among general practitioners (GPs).MethodsSemi-structured face-to face interviews were conducted with 16 GPs in the Rhône area of France to explore their knowledge and representations regarding osteoporosis. A thematic analysis of transcripts was performed to identify GPs’ perceptions on osteoporosis diagnosis, prevention, treatment and patients’ expectations.ResultsInterviewed GPs considered osteoporosis far less important than other chronic diseases. They questioned whether osteoporosis was a disease or normal aspect of ageing. They associated osteoporosis with fragility fractures, female sex, menopause, and old age but rarely with male sex. They regarded bone mineral density as the reference diagnostic test, but certain GPs indicated that they had difficulties to interpret the results and to know when to prescribe. Biphosphonates were mentioned as the reference treatment but some GPs expressed distrust about osteoporosis medications. Most of them did not think to screen for osteoporosis risk factors in their patients in a preventive medical approach. They mentioned the lack of time to implement prevention and were expecting clear and pragmatic guidelines, as well as information campaigns in general population to increase awareness on osteoporosis.ConclusionGPs tended to underestimate the salience of osteoporosis. Clear recommendations, better awareness of GPs and the general population could improve osteoporosis prevention and treatment.
Highlights
The burden of osteoporosis (OP) is increasing worldwide [1, 2]
They questioned whether osteoporosis was a disease or normal aspect of ageing. They associated osteoporosis with fragility fractures, female sex, menopause, and old age but rarely with male sex. They regarded bone mineral density as the reference diagnostic test, but certain general practitioners (GPs) indicated that they had difficulties to interpret the results and to know when to prescribe
Biphosphonates were mentioned as the reference treatment but some GPs expressed distrust about osteoporosis medications
Summary
In France, it is estimated that in 2010, 377 000 new osteoporotic fractures occurred, generating costs of nearly 4.8 million euros [3]. In France, the cost of fractures was estimated to rise by 26% between 2010 and 2025 to reach 6.1 million euros on the basis of expected changes in demographics [3]. Guidelines and evidence-based tools are available to help assess patients at increased risk of OP and fracture, and offer an appropriate management [8]. Guidelines are underused; awareness and management of OP are suboptimal leading to less than 20% of patients correctly managed after a low trauma fracture, despite availability of effective medications both worldwide and in France [2, 4, 12, 13].
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