INSERM Unité 1033, Université de Lyon, Lyon, France.
Hospices Civils de Lyon, HESPER EA, Université de Lyon, Lyon, France.
PLoS One. 2019 Jul 16;14(7):e0219681. doi: 10.1371/journal.pone.0219681. eCollection 2019.
Osteoporosis prevention, diagnosis and treatment remain suboptimal.
We conducted a qualitative study to understand barriers towards care initiation and levers to improve awareness and management of osteoporosis among general practitioners (GPs).
Semi-structured face-to face interviews were conducted with 16 GPs in the Rhône area of France to explore their knowledge and representations regarding osteoporosis. A thematic analysis of transcripts was performed to identify GPs' perceptions on osteoporosis diagnosis, prevention, treatment and patients' expectations.
Interviewed GPs considered osteoporosis far less important than other chronic diseases. They questioned whether osteoporosis was a disease or normal aspect of ageing. They associated osteoporosis with fragility fractures, female sex, menopause, and old age but rarely with male sex. They regarded bone mineral density as the reference diagnostic test, but certain GPs indicated that they had difficulties to interpret the results and to know when to prescribe. Biphosphonates were mentioned as the reference treatment but some GPs expressed distrust about osteoporosis medications. Most of them did not think to screen for osteoporosis risk factors in their patients in a preventive medical approach. They mentioned the lack of time to implement prevention and were expecting clear and pragmatic guidelines, as well as information campaigns in general population to increase awareness on osteoporosis.
GPs tended to underestimate the salience of osteoporosis. Clear recommendations, better awareness of GPs and the general population could improve osteoporosis prevention and treatment.
骨质疏松症的预防、诊断和治疗仍然不尽如人意。
我们进行了一项定性研究，以了解初级保健医生（GP）在启动骨质疏松症护理方面的障碍和提高对骨质疏松症的认识和管理的杠杆。
在法国罗纳地区对 16 名 GP 进行了半结构化的面对面访谈，以探讨他们对骨质疏松症的知识和认知。对转录本进行了主题分析，以确定 GP 对骨质疏松症诊断、预防、治疗和患者期望的看法。
接受采访的 GP 认为骨质疏松症远不如其他慢性病重要。他们质疑骨质疏松症是否是一种疾病或衰老的正常现象。他们将骨质疏松症与脆性骨折、女性、绝经和老年联系在一起，但很少与男性联系在一起。他们认为骨密度是参考诊断测试，但某些 GP 表示他们难以解释结果，也不知道何时开处方。双磷酸盐被认为是参考治疗方法，但一些 GP 对骨质疏松症药物表示不信任。他们中的大多数人没有考虑在预防性医疗方法中筛查患者的骨质疏松症风险因素。他们提到缺乏时间来实施预防措施，并期望有明确和务实的指南，以及在普通人群中开展宣传活动，以提高对骨质疏松症的认识。
GP 倾向于低估骨质疏松症的重要性。明确的建议、提高 GP 和普通大众的认识可以改善骨质疏松症的预防和治疗。
