Purpose We aimed to investigate barriers, enablers and other factors influencing the investigation and management of osteoporosis, using a qualitative approach. This paper analyses data from discussions with general medical practitioners (GPs) about their beliefs and attitudes regarding osteoporosis and its management. Methods Fourteen GPs and two practice nurses aged 27-89 years participated in four focus groups, from June 2010 to March 2011. Each group comprised 3-5 participants, and discussions were semi-structured, according to the protocol developed for the main study. Discussion points ranged from the circumstances under which GPs would initiate investigation for osteoporosis and their subsequent actions, to their views about treatment efficacy and patient adherence to prescribed treatment. Audio recordings were transcribed and coded for analysis, using analytic comparison to identify the major themes. Results The GPs were not particularly concerned about osteoporosis in their patients or the general population, ranking diabetes, osteoarthritis, cardiovascular disease and hypertension higher than concern about osteoporosis. They expressed confidence in the efficacy of antifracture medications, but were concerned about the potential financial burden on patients with limited incomes. The GPs were unsure about guidelines for investigation and management of osteoporosis in men, and the appropriate duration of treatment, particularly for the bisphosphonates in all patients. Conclusions The GPs' ambivalence about osteoporosis appeared to stem from structural factors such as financial barriers for patients and their own beliefs about the salience of osteoporosis. GPs considered the impact of investigating and prescribing treatment in the context of patients' whole lives.

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