How General Practitioners and Their Patients Adhere to Osteoporosis Management: A Follow-Up Survey among Czech General Practitioners

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.

Clinical Management of Women with Newly Diagnosed Osteoporosis: Data from Everyday Practice in Bulgaria

“…Only 40.3% of those with indications for treatment received BPs and 47.9% with calcium and vitamin D. In our study, about two-thirds of all treated patients received proper supplementation. A follow-up survey among Czech GPs revealed that only 60% of the respondents were adherent to the guidelines [ 15 ]. Calcium supplementation was started by 41% of the respondents and vitamin D by 40% only.…”

“…Calcium supplementation was started by 41% of the respondents and vitamin D by 40% only. This study focused attention to the lack of possibility to prescribe selected drugs (in 61%) and the financial limits introduced by the health insurance authorities (44%) [ 15 ]. All of this increased the financial burden on the patient in addition to the low willingness of patients to pay for drugs out of pocket [ 15 ].…”

“…This study focused attention to the lack of possibility to prescribe selected drugs (in 61%) and the financial limits introduced by the health insurance authorities (44%) [ 15 ]. All of this increased the financial burden on the patient in addition to the low willingness of patients to pay for drugs out of pocket [ 15 ]. Two studies looking at the barriers to improvement in GPs revealed that GPs considered osteoporosis far less important than other diseases and shared their uncertainties about the interpretation of BMD tests [ 7 , 16 ].…”

An Exploration of Current Primary Care Practice Regarding Osteoporosis Assessment Following a Low Trauma Wrist Fracture in people aged 50 years and above in Wellington, New Zealand: A Quantitative Survey

“…the key studies identified by the researcher (Blazkova et al, 2010;Chami et al, 2006;Khan et al, 2013;Vytrisalova et al, 2014;Vytrisalova et al, 2017) this study's results should be relatable to future comparable studies. Statistical input and advice were sought regularly throughout this research undertaking.…”

“…Unfortunately, no responses were received despite polite follow up email messages. The [36] survey tool utilised for this study was therefore, constructed by utilising the answers described in the relevant research studies for retrospective extrapolation of the answers, stemming from questions that were likely asked, see (Blazkova et al, 2010;Chami et al, 2006;Khan, Mallhi, Sarriff, & Khan, 2013;Vytrisalova et al, 2014;Vytrisalova et al, 2017).…”