School of Medicine, Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8100, St. Louis, MO, 63110, USA.
School of Medicine, Department of Rheumatology, Yale University, New Haven, CT, USA.
Osteoporos Int. 2019 Nov;30(11):2299-2310. doi: 10.1007/s00198-019-05008-4. Epub 2019 Jul 11.
Despite its effectiveness, bisphosphonate use for osteoporosis is low. We assessed bisphosphonate information on the internet and found the most commonly listed benefits/risks were bone density loss, gastrointestinal issues, and jaw necrosis, that risk quantification was rare, and information quality varied. Findings underscore the importance of clinical communication about bisphosphonates.
The US Preventative Services Task Force recommends osteoporosis screening and treatment with bisphosphonates in high-risk populations. However, bisphosphonate use among individuals with osteoporosis remains low. The content and quality of information from outside sources may influence individuals' bisphosphonate decisions. Therefore, we sought to assess the content and quality of osteoporosis treatment information available to the public by conducting an internet search and coding available bisphosphonate information.
Eleven search terms about osteoporosis and bisphosphonates were entered into four search engines. Two raters assessed websites for information about bisphosphonates, whether and how benefits and side effects were described and quantified, contraindications, and dosing instructions. Coders also assessed website interface and slant/balance of information.
One thousand four hundred seventy-three websites were identified. Two hundred twenty-seven websites met inclusion criteria and were coded. The most common bisphosphonate benefit described was prevention of bone density loss (77.1% of websites). The most common side effects described were gastrointestinal problems (66.1%) and jaw osteonecrosis (58.6%). Most websites did not quantify bisphosphonate benefits (78.0%) or side effects (82.4%). Complementary/integrative health websites (p < .001) and pharmaceutical litigation websites (p < .001) were more often slanted against taking bisphosphonates, compared to all websites coded. General medical knowledge websites were more balanced than other websites (p = .023).
The quality of bisphosphonate information on the internet varies substantially. Providers counseling patients about osteoporosis treatment should inquire about patients' baseline bisphosphonate knowledge. Providers can complement accurate information and address potential bisphosphonate misconceptions.
尽管双膦酸盐治疗骨质疏松症的效果显著，但实际应用率却很低。本研究旨在评估互联网上有关双膦酸盐的信息，并发现最常被提及的益处/风险为骨密度下降、胃肠道问题和颌骨坏死，风险量化罕见，信息质量参差不齐。这些发现强调了临床沟通在双膦酸盐治疗中的重要性。
美国预防服务工作组建议对高危人群进行骨质疏松症筛查和双膦酸盐治疗。然而，骨质疏松症患者中双膦酸盐的使用率仍然较低。来自外部资源的信息内容和质量可能会影响个人对双膦酸盐的决策。因此，我们通过互联网搜索并对可用的双膦酸盐信息进行编码，来评估公众可获得的骨质疏松症治疗信息的内容和质量。
输入 11 个有关骨质疏松症和双膦酸盐的搜索词到四个搜索引擎中。两名评估者评估了网站中关于双膦酸盐的信息，包括是否以及如何描述和量化益处和副作用、禁忌症和剂量说明。编码员还评估了网站界面和信息的倾斜/平衡。
共确定了 1473 个网站。227 个网站符合纳入标准并被编码。最常描述的双膦酸盐益处是预防骨密度下降（77.1%的网站）。最常描述的副作用是胃肠道问题（66.1%）和颌骨坏死（58.6%）。大多数网站未对双膦酸盐的益处（78.0%）或副作用（82.4%）进行量化。与所有编码网站相比，补充/综合健康网站（p<0.001）和药物诉讼网站（p<0.001）更倾向于反对使用双膦酸盐，而一般医学知识网站则比其他网站更为平衡（p=0.023）。
互联网上双膦酸盐信息的质量差异很大。为患者提供骨质疏松症治疗建议的医生应了解患者对双膦酸盐的基础知识。医生可以提供准确的信息，并解决潜在的双膦酸盐误解。
