Women Fear Losing Independence From Osteoporosis, Yet It's All About Broken Bones to Doctors -- New Survey Shows

A national survey released today highlights the importance of doctors understanding their patients' fears about osteoporosis and how those fears can motivate them to take their medication. The majority of women (57 percent) with osteoporosis who participated in the survey say that the desire to remain healthy and independent is what motivates them to take an osteoporosis medication. Yet most doctors (74 percent) believe the fear of breaking or fracturing a bone is what motivates their patients to treat this silent but potentially debilitating condition.

"It's clear that better doctor-patient communication is needed since doctors aren't tapping into the emotional catalysts that drive women to protect their bones, and by extension, their independence," says Daniel Perry, executive director of the Alliance for Aging Research. "Physicians and patients need to be speaking a common language to encourage more patients to start and stay on their osteoporosis medication since medication won't work if you don't take it."

The survey was conducted by the Opinion Research Corporation (ORC) in collaboration with the Alliance. Support and assistance for this survey campaign was provided by GlaxoSmithKline and Roche.

On the heels of the 2004 Surgeon General's Report on Bone Health and Osteoporosis elevating osteoporosis to a national health threat, the "Women's Bone Health Survey" asked 752 postmenopausal women diagnosed with osteoporosis and 352 physicians to offer an in-depth look at their respective attitudes and beliefs about protecting bone health. A key part of protecting bones in patients with osteoporosis is taking medication, yet 70 percent of physicians think that poor persistence (patients not staying on treatment for as long as needed) is a problem in their practice.

A recent study of prescription data on women with postmenopausal osteoporosis confirms this, as half to almost two-thirds discontinued their osteoporosis medication within one year(i). Further studies have also shown that lack of persistence with osteoporosis medication can potentially result in an increased risk for fractures(ii) and healthcare costs(iii).

The most commonly prescribed osteoporosis treatments are bisphosphonates. According to the "Women's Bone Health Survey," 67 percent of women who quit taking their bisphosphonate therapy (n=140) say they stopped because of side effects (primarily gastrointestinal discomfort). While women are aware of osteoporosis (six out of ten were not surprised when they were diagnosed with osteoporosis), it is not necessarily a priority for them. Almost half (47 percent) of women who went off their osteoporosis medication say they quit because other diseases or conditions are more important to them than treating their osteoporosis.

When physicians surveyed were asked why patients did not stay on their bisphosphonate therapy, the top three barriers listed were side effects (87 percent), taking too many pills for other conditions (68 percent) and other health concerns taking priority over treating osteoporosis (56 percent). These physicians feel that lack of perceived benefits of treatment (43 percent) and inconvenient dosing regimens (20 percent) are barriers, as well. However, almost all physicians (97 percent) surveyed believe that staying on osteoporosis prescription therapy (persistence) will reduce fracture risk.

In looking at ways to improve persistence, the Surgeon General's Report recommends research to examine whether lower doses, shorter courses or wider spacing of treatment can help encourage women to stick with treatment and take as directed -- thus preventing fractures(iv). The majority of physicians surveyed agrees and notes that simplifying and organizing the osteoporosis treatment regimen (88 percent) and wider spacing of treatments (80 percent) would help improve persistence. Eighty-two percent of doctors also agree that weekly osteoporosis treatments have helped patients stay on therapy longer than daily dosing, but that persistence is still suboptimal. Patients concur, as 44 percent of women surveyed indicated they would try a medication dosed less frequently than weekly.

The "Women's Bone Health Survey" also revealed that doctors and patients may not be speaking the same language, nor speaking often enough, about osteoporosis. More than half of doctors (56 percent) do not speak with their osteoporosis patients about the condition at each visit, and two-thirds of patients surveyed (62 percent) agree.

To improve the communication process between patients and physicians, the Alliance has developed a free discussion guide for use by patients and physicians during office visits. The guide provides questions, tips and advice to facilitate better communication and understanding of osteoporosis risks, preventions and treatment. To sign up to receive the free guide, patients and physicians can go to www.agingresearch.org.

"Women continue to put themselves at risk for fractures that can lead to pain, physical disability, loss of independence and even premature death by stopping osteoporosis treatment too soon," says Dr. Sydney L. Bonnick, Medical Director of the Clinical Research Center of North Texas in Denton, TX. "This guide will encourage better dialogue between patients and physicians to help guard against these risks."

About the "Women's Bone Health Survey"

Respondents were contacted via telephone between December 14, 2004 and January 5, 2005 and included: 752 females, between 50 and 80 years of age (including 140 previous bisphosphonate users) and 352 physicians (primary care and obstetrician/gynecologist). All patients were identified through the Experian database and self-reported having a diagnosis of osteoporosis. A random sample of physicians identified through InfoUSA's national database of physicians was invited to participate in the survey. The female survey has a margin of error of plus or minus four percent, while the margin of error for the physician survey is plus or minus five percent.

About Osteoporosis

Osteoporosis (porous bones) is a disease in which bones become brittle and more likely to break. Common and chronic conditions, osteoporosis and low bone mass (osteopenia) pose a major public health threat to more than 44 million Americans over age 50(v). In the U.S. today, ten million individuals, eight million of whom are women, are estimated to already have osteoporosis, and almost 34 million more are estimated to have osteopenia, placing them at increased risk for osteoporosis(v). Unfortunately, the prevalence of osteoporosis is growing, especially as the number of postmenopausal women in the population continues to rise. An estimated 52 million women and men age fifty plus are expected to be affected by osteoporosis and osteopenia by 2010 and 61 million are expected to be affected by 2020(v).

About the Alliance for Aging Research

Founded in 1986, the Alliance for Aging Research is a nonprofit, independent organization dedicated to improving the health and independence of aging Americans through public and private funding of medical research and geriatric education. The Alliance combines the interests of top scientists, public officials, business executives and foundation leaders to promote a greater national investment in research and new technologies that will prepare our nation for the coming senior boom, and improve the quality of life for today's older generation.

References

(i) Data on file. (Ref 161-011), Hoffmann-La Roche Inc., Nutley, NJ

(ii) Caro JJ, Ishak K, Huybrechts K, Raggio G, Naujoks C. The impact of compliance with osteoporosis therapy on fracture rates in actual practice. Osteoporos. Int. 2004; (12):1003-1008.

(iii) McCombs JS, Thiebaud P, McLaughlin-Miley C, Shi J. Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas. 2004;48(3):271-87

(iv) Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; 2004.

(v) America's Bone Health: The State of Osteoporosis and Low Bone Mass in Our Nation. The National Osteoporosis Foundation. February 2002.

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