Knowledge gap regarding osteoporosis among medical professionals in Southern India

Abstract

Rationale, aims, and objectives:Osteoporosis is a common health problem in India, which leads to significant morbidity and mortality in elderly individuals. Lack of knowledge and awareness among medical professionals is one of the important barriers in management of these patients. Therefore, this study was conducted to assess knowledge pertaining to diagnosis and treatment of osteoporosis among a group of Indian medical practitioners. Methods:The study participants included 222 allopathic medical professionals, either graduate or postgraduate working in primary or secondary health care levels. They were assessed using a previously validated Fogelman's multiple choice questionnaire. Out of a total of 18 questions, four questions pertained to knowledge of diagnosis, three questions to treatment decisions, one question to assess knowledge regarding recommended dosage of vitamin D and calcium supplementation, five questions concerned medication use, and the rest to assess attitude and practices. The correct answers were converted into scores and expressed as percentages with a maximum of 100. Results:The mean total score among them was 22.5%, which was quite low.Almost all of them had a score of less than 50%. Medical practitioners performed better in diagnosis-related questions, (19.4% answered all options correctly) than in medication knowledge (no correct response regarding side effects and 2% regarding contraindications). In treatment-related decisions, 37.4% answered correctly for duration of treatment, and 59% answered correctly for treatment goal. Only 1.4% of themwere able to answer correctly regarding recommended calcium and vitamin D intake.Professional literature, conferences, and Continuing Medical Education (CME's) were regarded as the main sources of information on the subject by 40% of practitioners. Conclusion:This study showed suboptimal knowledge among a group of medical professionals regarding various aspects of diagnosis and management of osteoporosis, and it stipulates the need for escalating the efforts to improve their knowledge regarding various aspects of osteoporosis.

To study the awareness of osteoporosis in postmenopausal Indian women in a Northeast part of India

“…[ 21 ] Few authors from India reported poor awareness of osteoporosis in postmenopausal women are noted. [ 18 22 23 24 ]…”

Utility of FRAX (fracture risk assessment tool) in primary care and family practice setting in India

“…There are more than 100 million postmenopausal women in India, and more than two-thirds of them reside in rural areas. [414] Therefore, primary care physicians and family care practitioners play an important role in pre-emptively screening them for fracture risk. As the availability of DXA scanners is limited in resource poor conditions, FRAX may be utilized to identify those at risk for osteoporotic fractures.…”

“…The reasons cited for this include less awareness among primary care and family physicians about the need for referral and treatment, limited access to an ideal diagnostic modality like dual-energy X-ray absorptiometry (DXA) scan, and lack of precise fracture risk prediction tools. [45]…”

Trabecular bone score—An emerging tool in the management of osteoporosis

“…Osteoporosis, which is reported to occur in about 25–60% of Indian postmenopausal women, is a common, yet under recognized public health problem. [ 1 2 ] The lifetime risk of osteoporotic fracture is around 40–50% in women and the mortality rate following fragility fractures is as high as 25% in the first year. [ 3 ]…”