Modi A, Ebeling P R, Lee M S, Min Y K, Mithal A, Yang X, Baidya S, Sen S, Sajjan S
Center for Observational and Real-World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA.
Monash University, Clayton, Australia.
Bone Rep. 2017 Sep 20;7:108-113. doi: 10.1016/j.bonr.2017.09.003. eCollection 2017 Dec.
The objectives of the physician survey component of the MUSIC OS-AP study were to describe physicians' approaches to treatment of women with postmenopausal osteoporosis and to understand the influence of gastrointestinal (GI) events on treatment in clinical practice.
Physicians were recruited from 5 Asia-Pacific countries. Questionnaires collected information about physicians' standard practices for treatment of patients with osteoporosis, as well as their perspectives on the influence of GI events on osteoporosis treatment approaches.
A total of 59 physicians participated in the study. The most frequently prescribed or recommended treatments were vitamin D (84% of patients), calcium (82%), and oral bisphosphonates (59%). When choosing a medication for treatment-naïve patients, GI sensitivity was often or always a factor for 79% of physicians. Among physicians not prescribing pharmacologic treatment, a mean of 18% of non-prescriptions were due to GI sensitivity. For patients with pre-existing GI conditions, physicians most frequently ranked use of non-oral osteoporosis medication as the first treatment strategy (47%), followed by co-prescription with a proton pump inhibitor or other gastro-protective agent (31%). For patients developing GI symptoms after starting pharmacologic treatment, the most frequently first-ranked management strategy was to check if patients were taking their osteoporosis medication correctly as prescribed (64%), followed by temporary discontinuation of the medication (i.e., a drug holiday) until GI events have resolved (31%) and co-prescription with a proton pump inhibitor or other gastroprotective agent (24%).
These results suggest that GI events influence the prescribing practices of physicians in the Asia-Pacific region and sometimes result in non-treatment of women with osteoporosis.
MUSIC OS-AP研究中医生调查部分的目的是描述医生治疗绝经后骨质疏松症女性的方法，并了解胃肠道（GI）事件对临床实践中治疗的影响。
从5个亚太国家招募医生。问卷收集了有关医生治疗骨质疏松症患者的标准做法的信息，以及他们对GI事件对骨质疏松症治疗方法影响的看法。
共有59名医生参与了该研究。最常开具或推荐的治疗方法是维生素D（84%的患者）、钙（82%）和口服双膦酸盐（59%）。在为初治患者选择药物时，79%的医生经常或总是将GI敏感性作为一个因素。在未开具药物治疗的医生中，平均18%的未处方是由于GI敏感性。对于已有GI疾病的患者，医生最常将使用非口服骨质疏松症药物作为首选治疗策略（47%），其次是联合使用质子泵抑制剂或其他胃保护剂（31%）。对于开始药物治疗后出现GI症状的患者，最常首选的管理策略是检查患者是否按规定正确服用骨质疏松症药物（64%），其次是暂时停药（即药物假期）直至GI事件解决（31%）以及联合使用质子泵抑制剂或其他胃保护剂（24%）。
这些结果表明，GI事件影响亚太地区医生的处方行为，有时会导致骨质疏松症女性得不到治疗。
