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09-05-2011 | Bone health | Article

Decision to take osteoporosis medication often ‘difficult’


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MedWire News: Just under half of osteoporosis patients find the decision to take medication following a fragility fracture is not an easy one, Canadian study data show.

Regardless of how difficult the decision was, many patients suggested that they could be persuaded to change their mind about whether to start or stop taking medication dependent on circumstances, report Joanna Sale (University of Toronto, Ontario, Canada) and colleagues.

Because few studies have examined the factors that influence the initial decision to take osteoporosis medication, Sale and team conducted a qualitative analysis among six men and 15 women aged 65-88 years, who had sustained a fragility fracture within the previous 5 years.

All of the patients had been prescribed osteoporosis medication, and the researchers interviewed them about how they decided whether to take this medication or not.

Sale and team found that nine of the patients had osteoporosis and the remainder had osteopenia. At the time of the interviews, 14 patients were taking an oral osteoporosis drug, while the remaining seven patients were not taking their prescribed osteoporosis medications.

Twelve patients reported that the decision to take, or not take, osteoporosis medication was relatively easy, involved minimal contemplation or distress, and occurred at the time the prescription was given. Of these patients, 10 opted to take the medication, one did not start the medication, and one initiated then stopped treatment.

All 12 patients who said choosing whether or not to take medication was easy said they made their decision because they liked/trusted their healthcare provider. In spite of this, four indicated that their current medication status might change.

Nine patients reported greater difficulty making their decision, they needed time to think and took several factors into consideration when making their choice. The team observed that these patients were unconvinced by their healthcare provider, engaged in risk-benefit analyses using other information sources, and were concerned about side effects.

Four of the nine patients who said their treatment decision was more difficult were taking osteoporosis medication at the time of the interview, while five were not, and seven indicated that their medication status might change at a later date.

Sale and co-authors note that although the sample size was small, it meets the recommendations for this type of study.

They conclude in the journal BMC Musculoskeletal Disorders: "Healthcare providers should be aware of their potential role in patients' decisions and [should] monitor patients' decisions over time."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Laura Dean

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