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    Patient decision to initiate therapy for osteoporosis: the influence of knowledge and beliefs

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    Authors
    Yood, Robert A.
    Mazor, Kathleen M.
    Andrade, Susan E.
    Emani, Srinivas
    Chan, Wing
    Kahler, Kristijan H.
    UMass Chan Affiliations
    Meyers Primary Care Institute
    Document Type
    Journal Article
    Publication Date
    2008-11-13
    Keywords
    Adult
    Aged
    Bone Density Conservation Agents
    Cohort Studies
    Female
    *Health Knowledge, Attitudes, Practice
    Health Surveys
    Humans
    Managed Care Programs
    *Medication Adherence
    Middle Aged
    Osteoporosis
    Patient Satisfaction
    Health Services Research
    Primary Care
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    Link to Full Text
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585659/pdf/11606_2008_Article_772.pdf
    Abstract
    BACKGROUND: There are effective treatments to prevent osteoporotic fractures, but these treatments are underutilized. OBJECTIVE: To evaluate the influence of patient characteristics, perceptions, knowledge and beliefs about osteoporosis on the decision to initiate osteoporotic treatment. PARTICIPANTS: We identified female members of a managed care plan who had a dual energy x-ray absorptiometry (DXA) bone density test and fulfilled World Health Organization criteria for osteoporosis. Patients were excluded if they received osteoporotic medications in the prior 6 months. MEASUREMENTS: Patients were sent a questionnaire that included items assessing satisfaction with physician-patient communication, trust in the physician, osteoporosis knowledge and beliefs, beliefs about prescription medications, and perceptions of barriers to medication use. Administrative electronic health records were used to identify prescription drug use and health care utilization. RESULTS: Two hundred and thirty-six women returned surveys and research authorization forms out of 465 contacted for participation. One hundred and thirty-five (57.2%) filled a prescription for an osteoporotic drug in the first 3 months after the DXA exam. The largest differences between initiators and non-initiators were in beliefs in the benefits of medications, and distrust of medications, with initiators believing more strongly in the benefits and effectiveness of medications (p < .001), and non-initiators reporting more distrust of medications (p < .001). Osteoporosis knowledge and the belief that osteoporosis is a serious disease were also related to therapy initiation in bivariate analysis. CONCLUSIONS: Only 57% of patients initiated osteoporotic medication within 3 months of diagnosis. The decision to start osteoporosis treatment appeared to be related to a patient's beliefs in the effectiveness of osteoporosis medications and distrust of medications.
    Source
    J Gen Intern Med. 2008 Nov;23(11):1815-21. Epub 2008 Sep 12. Link to article on publisher's site
    DOI
    10.1007/s11606-008-0772-0
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/37039
    PubMed ID
    18787907
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11606-008-0772-0
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