Osteoporosis Practice Patterns in 2006 Among Primary Care Physicians Participating in the NORA Study

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2007 Jun 20

PMID 17577594

Citations 10

Authors

T W Weiss

E S Siris

E Barrett-Connor

P D Miller

C A McHorney

Affiliations

Soon will be listed here.

Abstract

Unlabelled: This study investigated osteoporosis management trends from 1998 to 2006 among 808 primary care physicians involved in the US-based NORA (National Osteoporosis Risk Assessment) study. These results suggest some significant improvements in osteoporosis management over the past eight years.

Introduction: The purpose of this study was to investigate osteoporosis management trends among a large cohort of primary care physicians (PCPs) involved in the US-based NORA (National Osteoporosis Risk Assessment) study.

Methods: In 2006, we undertook a resurvey of the 2,836 NORA PCPs who completed a baseline survey in 1998. Of the 2,199 PCPs for whom we had current contact information and who were still practicing, we collected usable surveys from 808 (37% response rate).

Results: From 1998 to 2006, more than double the percentage of NORA PCPs reported using BMDs "often" (35% vs. 87%). There was a doubling of the percentage of NORA PCPs who reported that a T-score of < or = -2.5 was the threshold indicating the presence of osteoporosis (34% vs. 67%). The percentage of NORA PCPs who reported using bone turnover markers to screen, diagnosis, or monitor osteoporosis almost tripled (19% vs. 55%). The percentage of patients prescribed or recommended hormone therapy dropped sixfold (67% to 11%), and the percentage of patients prescribed bisphosphonates increased fourfold from 15% to 59%.

Conclusion: These results suggest some significant improvements in osteoporosis management over the past eight years.

Citing Articles

General practitioner gender and use of diagnostic procedures: a French cross-sectional study in training practices.

Bouissiere A, Laperrouse M, Panjo H, Ringa V, Rigal L, Letrilliart L BMJ Open. 2022; 12(5):e054486.

PMID: 35523487 PMC: 9083381. DOI: 10.1136/bmjopen-2021-054486.

Practice of Family Physicians in the Management of Osteoporosis Among Older Female Patients at King Abdulaziz Medical City, Riyadh, Saudi Arabia.

AlAnazi S, AlKhamali A, AlAteeq M Cureus. 2022; 14(2):e22387.

PMID: 35371702 PMC: 8936228. DOI: 10.7759/cureus.22387.

Use of Bone Turnover Markers in Clinical Practice for the Management of Osteoporosis in Korea: From the Survey on the Prescription Pattern of Bone Turnover Markers.

Ahn S, Park S, Yoo J, Chung Y, Jeon Y, Yoon B J Bone Metab. 2019; 26(4):271-277.

PMID: 31832393 PMC: 6901689. DOI: 10.11005/jbm.2019.26.4.271.

Physicians' perspectives on the treatment of osteoporosis patients with bisphosphonates.

Gu T, Eisenberg Lawrence D, Stephenson J, Yu J Clin Interv Aging. 2016; 11:1-8.

PMID: 26929609 PMC: 4760663. DOI: 10.2147/CIA.S97593.

Self-reported calcium use in a cohort of postmenopausal women receiving osteoporosis therapy: results from POSSIBLE US™.

Barrett-Connor E, Wade S, Downs R, Ganiats T, Hochberg M, Recker R Osteoporos Int. 2015; 26(8):2175-84.

PMID: 25876880 DOI: 10.1007/s00198-015-3128-8.

References

Romagnoli E, Colangeli I, Minisola S . Awareness, attitudes and opinions on osteoporosis of primary care physicians working in the metropolitan area of Rome: a brief report. Aging (Milano). 2000; 12(3):240-4. DOI: 10.1007/BF03339842. View

Fleming R, Patrick K . Osteoporosis prevention: pediatricians' knowledge, attitudes, and counseling practices. Prev Med. 2002; 34(4):411-21. DOI: 10.1006/pmed.2002.1006. View

Burge R, Dawson-Hughes B, Solomon D, Wong J, King A, Tosteson A . Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2006; 22(3):465-75. DOI: 10.1359/jbmr.061113. View

Holick M . High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc. 2006; 81(3):353-73. DOI: 10.4065/81.3.353. View

Perreault S, Dragomir A, Desgagne A, Blais L, Rossignol M, Blouin J . Trends and determinants of antiresorptive drug use for osteoporosis among elderly women. Pharmacoepidemiol Drug Saf. 2005; 14(10):685-95. DOI: 10.1002/pds.1068. View

. Management of postmenopausal osteoporosis: position statement of the North American Menopause Society. Menopause. 2002; 9(2):84-101. View

Melton 3rd L, Crowson C, OFallon W, Wahner H, Riggs B . Relative contributions of bone density, bone turnover, and clinical risk factors to long-term fracture prediction. J Bone Miner Res. 2003; 18(2):312-8. DOI: 10.1359/jbmr.2003.18.2.312. View

Garnero P, Delmas P . Contribution of bone mineral density and bone turnover markers to the estimation of risk of osteoporotic fracture in postmenopausal women. J Musculoskelet Neuronal Interact. 2004; 4(1):50-63. View

Perez-Edo L, Ciria Recasens M, Castelo-Branco C, Orozco Lopez P, Gimeno Marques A, Perez C . Management of osteoporosis in general practice: a cross-sectional survey of primary care practitioners in Spain. Osteoporos Int. 2004; 15(3):252-7. DOI: 10.1007/s00198-003-1569-y. View

10.

. Recommendations for estrogen and progestogen use in peri-and postmenopausal women: October 2004 position statement of The North American Menopause Society. Menopause. 2004; 11(6 Pt 1):589-600. DOI: 10.1097/01.gme.0000145876.76178.dc. View

11.

Werner P, Vered I . Management of osteoporosis: a survey of Israeli physicians' knowledge and attitudes. Isr Med Assoc J. 2000; 2(5):361-4. View

12.

Miller P, Hochberg M, Wehren L, Ross P, Wasnich R . How useful are measures of BMD and bone turnover?. Curr Med Res Opin. 2005; 21(4):545-54. DOI: 10.1185/030079905x41390. View

13.

Siris E, Miller P, Barrett-Connor E, Abbott T, Sherwood L, Berger M . Design of NORA, the National Osteoporosis Risk Assessment Program: a longitudinal US registry of postmenopausal women. Osteoporos Int. 1998; 8 Suppl 1:S62-9. View

14.

Holick M, Siris E, Binkley N, Beard M, Khan A, Katzer J . Prevalence of Vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab. 2005; 90(6):3215-24. DOI: 10.1210/jc.2004-2364. View

15.

Solomon D, Connelly M, Rosen C, Dawson-Hughes B, Kiel D, Greenspan S . Factors related to the use of bone densitometry: survey responses of 494 primary care physicians in New England. Osteoporos Int. 2003; 14(2):123-9. DOI: 10.1007/s00198-002-1326-7. View

16.

Miller P, Siris E, Barrett-Connor E, Faulkner K, Wehren L, Abbott T . Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: evidence from the National Osteoporosis Risk Assessment. J Bone Miner Res. 2002; 17(12):2222-30. DOI: 10.1359/jbmr.2002.17.12.2222. View

17.

. Screening for osteoporosis in postmenopausal women: recommendations and rationale. Ann Intern Med. 2002; 137(6):526-8. DOI: 10.7326/0003-4819-137-6-200209170-00014. View

18.

Skedros J, Holyoak J, Pitts T . Knowledge and opinions of orthopaedic surgeons concerning medical evaluation and treatment of patients with osteoporotic fracture. J Bone Joint Surg Am. 2006; 88(1):18-24. DOI: 10.2106/JBJS.D.02949. View

19.

Stafford R, Drieling R, Hersh A . National trends in osteoporosis visits and osteoporosis treatment, 1988-2003. Arch Intern Med. 2004; 164(14):1525-30. DOI: 10.1001/archinte.164.14.1525. View

20.

Giangregorio L, Papaioannou A, Cranney A, Zytaruk N, Adachi J . Fragility fractures and the osteoporosis care gap: an international phenomenon. Semin Arthritis Rheum. 2006; 35(5):293-305. DOI: 10.1016/j.semarthrit.2005.11.001. View