Dorner Thomas, Lawrence Kitty, Rebhandl Erwin, Weichselbaum Elisabeth, Rieder Anita
Centre for Public Health, Institute of Social Medicine, Medical University of Vienna, Vienna, Austria.
Wien Med Wochenschr. 2009 May;159(9-10):247-52. doi: 10.1007/s10354-009-0648-x.
General practitioners play a crucial role in the management of osteoporosis. Thus, it is essential to determine the opinions and attitudes of family doctors concerning this disease. A structured pencil-paper questionnaire was distributed to all general physicians in a practice in Austria and 3.2% responded. Results were compared with a similar survey carried out in 1993. 84.4% of the responding doctors regarded the public health impact of osteoporosis as rather or very important, compared with 49.2% in 1993. 83.3% regarded prevention of osteoporosis as effective or very effective. This proportion rose from 66.2% in 1993. Regular physical exercise was rated as most effective in the prevention of osteoporosis, followed by calcium-rich diet and vitamin D- and calcium supplementation. 33.6% reported carrying out a standardised risk assessment prior to referral/non-referral for bone mineral densitometry. The most frequently cited aspects of the patient's medical history leading to this examination were permanent corticosteroid therapy, a history of fractures, and pain, as reported by 93.6, 84.6 and 71.2%, respectively. The most frequently reported interventions recommended by doctors to their osteoporosis patients in the prevention of falls were reduction of trip hazards (87.2%), reduction of psychotropic drugs (50.0%), balance, strength and endurance training (57.7, 48.1, and 42.3%, respectively). These results reveal strengths in the approach to prevention and early recognition of osteoporosis and prevention of falls, but potential room for improvement in the management of osteoporosis by general practitioners is also shown.
全科医生在骨质疏松症的管理中发挥着关键作用。因此，确定家庭医生对这种疾病的看法和态度至关重要。一份结构化的纸质问卷被分发给奥地利一家诊所的所有全科医生，3.2%的医生做出了回应。结果与1993年进行的一项类似调查进行了比较。84.4%的回应医生认为骨质疏松症对公共健康的影响相当重要或非常重要，而1993年这一比例为49.2%。83.3%的医生认为骨质疏松症的预防有效或非常有效。这一比例从1993年的66.2%上升。定期体育锻炼被认为是预防骨质疏松症最有效的方法，其次是富含钙的饮食以及补充维生素D和钙。33.6%的医生报告称在转诊/不转诊进行骨密度测量之前会进行标准化风险评估。导致进行这项检查的患者病史中最常被提及的方面分别是长期使用皮质类固醇治疗、骨折史和疼痛，报告比例分别为93.6%、84.6%和71.2%。医生向骨质疏松症患者推荐的预防跌倒的最常报告的干预措施是减少绊倒危险（87.2%）、减少精神药物使用（50.0%）、平衡、力量和耐力训练（分别为57.7%、48.1%和42.3%）。这些结果揭示了在骨质疏松症预防和早期识别以及预防跌倒方面的优势，但也显示出全科医生在骨质疏松症管理方面仍有改进的空间。
