Barriers to Effective Postmenopausal Osteoporosis Treatment: A Qualitative Study of Patients' and Practitioners' Views

Abstract : Objective: Study patients’ and physicians’ views regarding postmenopausal osteoporosis (PMO) to identify impediments to good care. Methods: A qualitative study involving 18 physicians and 37 women (age 57–87) with PMO. Results: All women interviewed considered PMO to be somewhat normal wear-and-tear associated with old age. The women identified a large number of "causes" for osteoporosis but finally viewed it as chance. They all described its progression as slow. Three representations of PMO severity were identified: some women tended to interpreted it as benign (21), others tended to dramatize it (11), and the rest were uncertain (5). These representations did not appear linked to age or fracture. Even the women who associated fracture and PMO were uncertain of the link between them. Fractures were considered to be random events, independent of osteoporosis. Women received general life-style recommendations from their physicians positively, but did not connect them specifically to osteoporosis. Indeed, these recommendations, along with the fear of side effects, the absence of tangible results of treatments, the view of PMO as a natural process, and the representations of PMO severity are factors that may deter treatments and impact compliance. As for the physicians, they identified eight risk factors, recognizing menopause as central to PMO and recognized the link between risk of fracture and PMO. However, some considered the impact of fractures to be limited in time, and viewed PMO as a "benign" disease. Seeing the progression of PMO as slow and inevitable reduced their urgency to diagnose and treat it as compared to other diseases. Some physicians acknowledged limited mastery of the existing therapeutic arsenal and unsuccessful handling of patient compliance. Conclusion: Women’s and physicians’ perspectives on PMO converged to trivialize postmenopausal osteoporosis and thus disqualify it as a legitimate disease. A better understanding of women’s and physicians’ views, practices, and concerns related to PMO can improve osteoporosis management.
Type de document :
Article dans une revue
PLoS ONE, Public Library of Science, 2016, 11 (6), pp.e0158365. 〈10.1371/journal.pone.0158365〉
Liste complète des métadonnées

Littérature citée [41 références]  Voir  Masquer  Télécharger

https://hal.archives-ouvertes.fr/hal-01520976
Contributeur : Spire Sciences Po Institutional Repository <>
Soumis le : mardi 30 janvier 2018 - 11:53:20
Dernière modification le : mercredi 31 janvier 2018 - 15:16:37
Document(s) archivé(s) le : vendredi 25 mai 2018 - 22:47:27

Fichier

journal.pone.0158365.PDF
Fichiers éditeurs autorisés sur une archive ouverte

Identifiants

Collections

Citation

Sophie Alami, Lucile Hervouet, Serge Poiraudeau, Karine Briot, Christian Roux. Barriers to Effective Postmenopausal Osteoporosis Treatment: A Qualitative Study of Patients' and Practitioners' Views. PLoS ONE, Public Library of Science, 2016, 11 (6), pp.e0158365. 〈10.1371/journal.pone.0158365〉. 〈hal-01520976〉

Partager

Métriques

Consultations de la notice

217

Téléchargements de fichiers

57