Study Identifies Barriers to Osteoporosis Prevention

SEATTLE — The fact that older adults are not concerned about osteoporosis and that physicians may underestimate its importance in the aging population may be partially responsible for suboptimal prevention and treatment of osteoporosis, according to study results.

The data, which were presented at the American Society for Bone and Mineral Research (ASBMR) 2015 Annual Meeting, suggest that there are many barriers to effectively preventing osteoporosis — most of which are related to a lack of awareness and education.

“The problem is not just with the patients but with the general practitioners as well,” said Blandine Merle, PhD, a research scientist with INSERM in Lyon, France. “The general practitioner doesn’t have time to do prevention. The patients tend to have more pressing medical issues.”

Additionally, she explained that many people are not concerned with osteoporosis because it is a “silent disease.” Moreover, men often view it as a woman’s disease, not one that affects them.

Dr Merle and colleagues conducted a qualitative study to explore the knowledge and representations regarding osteoporosis and its prevention. 

As part of this investigation, they set up several different types of focus groups with women aged 50 to 85 years and men aged 60 to 85 years, with or without a history of fragility fracture or an osteoporosis diagnosis in France. In these focus groups, there were 57 men, 45 women, and 16 general practitioners.

The researchers found that osteoporosis was not even considered an illness by men and women. Instead, both men and women believed it was simply associated with aging, even if they had suffered a fragility fracture. 

Surprisingly, there were no differences observed between men and women with or without a history of fragility fracture or an osteoporosis diagnosis. The fracture was often seen as being related to the fall as opposed to having osteoporosis, according to the study results.

When discussing treatment of osteoporosis, pharmacological treatments were mentioned only by women and not men. In addition, all the women mentioned pharmacological treatments with suspicion and cited potential adverse side effects.  

The researchers also found that both men and women thought their general practitioner was the right person to discuss osteoporosis with them.

“We need to make sure patients are getting a clear message and not getting too many mixed messages. We need to make doctors sensitive to this situation because there are more cases of osteoporosis. It is going up in incidence because of old age, and it is associated with aging,” Dr Merle said in an interview with Endocrinology Advisor.

Among general practitioners, osteoporosis was believed to be associated with fragility fractures, women, menopause, and old age. However, they rarely viewed it as being associated with men.

Dr Merle noted that there is a need for greater education of clinicians as well as a greater understanding of the guidelines on osteoporosis prevention and treatment.

“The surprising thing is that the female patients were waiting for the doctors to talk to them about it and the doctors are waiting for more clear guidelines,” said Dr Merle.   

The findings from this study suggest that many adults may not be aware of their susceptibility to osteoporosis and do not see the benefit of prevention.

It is hoped this information can help in developing improved information and awareness campaigns, she concluded.

Reference

1. Merle B. Abstract SA0271: Osteoporosis Prevention: Where are the barriers to improvement in patients and doctors? Presented at: American Society for Bone and Mineral Research (ASBMR) 2015 Annual Meeting; Oct. 9-12, 2015; Seattle.