ArticleBMC family practice2018
Factors related to intentional non-initiation of bisphosphonate treatment in patients with a high fracture risk in primary care: a qualitative study.
Article in BMC family practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 4 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 4 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Bisphosphonate alternative regimens for the prevention of osteoporotic fragility fractures: BLAST-OFF, a mixed-methods study.Health technology assessment (Winchester, England) · 2024Pooled it
- Healthcare professionals' perspectives and experiences of osteoporosis medication treatment: a qualitative systematic review.Archives of osteoporosis · 2024Pooled it
- Executive summary: Italian guidelines for diagnosis, risk stratification, and care continuity of fragility fractures 2021.Frontiers in endocrinology · 2023Pooled it
- Acceptability of bisphosphonates among patients, clinicians and managers: a systematic review and framework synthesis.BMJ open · 2020Pooled it
- Osteoporosis and post-fracture management in the primary care setting: a systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Review
- Time to reframe osteoporosis: a position statement to characterize the osteoporosis care gap.JBMR plus · 2026Review
- Barriers and Facilitators to Self-Care Behaviors in People Living with Osteoporosis: A Qualitative Descriptive Study.Nursing reports (Pavia, Italy) · 2026Article
- Declining Trend in Anti-osteoporotic Treatment, Despite a Rise in DEXA Screening Following "Sentinel" Distal Radius Fractures.Hand (New York, N.Y.) · 2024Article
- Secondary fracture prevention in primary care: a narrative review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Review
- Role of bisphosphonates in osteoporosis caused by adult growth hormone deficiency.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2024Review
- Osteoporosis: a problem still faulty addressed by the Romanian healthcare system. Results of a questionnaire survey of people aged 40 years and over.Frontiers in medicine · 2024Article
- Article
- The Phenotype of Bone Turnover in Patients with Fragility Hip Fracture: Experience in a Fracture Liaison Service Population.International journal of environmental research and public health · 2022Article
- Factors associated with initiation of bone-health medication among older adults in primary care in Ireland.Age and ageing · 2021Article
- Preventing hip fractures with multidisciplinary teams: a Canadian perspective.Canadian journal of surgery. Journal canadien de chirurgie · 2021Review
- Challenges and opportunities to improve fracture liaison service attendance: fracture registration and patient characteristics and motivations.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdherence to osteoporosis treatment is crucial for good treatment effects. However, adherence has been shown to be poor and a substantial part of the patients don't even initiate treatment. This study aimed to gain insight into the considerations of both osteoporosis patients and general practitioners (GP) concerning intentional non-initiation of bisphosphonate treatment.
methodsOsteoporosis patients and GPs were recruited from the SALT Osteoporosis Study and a transmural fracture liaison service, both carried out in the Netherlands. Using questionnaires, we identified non-starters and starters of bisphosphonate treatment. Semi-structured interviews were conducted to gain a detailed overview of all considerations until saturation of the data was reached. Starters were asked to reflect on the considerations that were brought forward by the non-starters. Interviews were open coded and the codes were classified into main themes and subthemes using an inductive approach.
results16 non-starters, 10 starters, and 13 GPs were interviewed. We identified three main themes: insufficient medical advice, attitudes towards medication use including concerns about side effects, and disease awareness. From patients' as well as GPs' perspective, insufficient or ambiguous information from the GP influenced the decision of the non-starters to not start bisphosphonates. In contrast, starters were either properly informed, or they collected information themselves. Patients' aversion towards medication, fear of side effects, and a low risk perception also contributed to not starting the medication, whereas starters were aware of their fracture risk and were confident of the outcome of the treatment. Concerns about osteoporosis treatment and its side effects were also expressed by several GPs. Some GPs appeared to have a limited understanding of the current osteoporosis guidelines and the indications for treatment.
conclusionsMany reasons we found for not starting bisphosphonate treatment were related to the patients or the GPs themselves being insufficiently informed. Attitudes of the GPs were shown to play a role in the decision of patients not to start treatment. Interventions need to be developed that are aimed at GPs, and at education of patients.
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