Management of osteoporosis in general practice: a cross-sectional survey of primary care practitioners in Spain
- 156 Downloads
A cross-sectional survey was conducted to determine the current situation in Spain regarding diagnosis and care of patients with osteoporosis in the primary care setting. A total of 2,500 primary care physicians who were homogeneously grouped in autonomous communities throughout the country received a postal 30-item anonymous self-administered questionnaire. The questionnaire covered demographics and personal characteristics of the physicians, conditions in everyday consultation, and degree of knowledge with regard to risk factors, diagnosis, treatment, and follow-up of the disease. The overall response was 850 (34%). The mean age of physicians surveyed was 43 years (range 23−66 years). The percentage of physicians specialized in community and family medicine was 46.7%. In 55.2% of cases, years of practice ranged between 11 and 20, and 55.7% of physicians visited between 31 and 50 patients per day. Age and years of practice were not associated with daily number of visits. Only 4% of physicians stated that there were specific programs for osteoporosis implemented in their primary care center. Diagnostic complementary investigations that could be ordered included plain radiographs in 96.2% of cases and bone densitometry in 27.8%. Laboratory tests included serum hormones in 61.6% of cases, PTH in 50.2%, and bone alkaline phosphatase in 33.4%. The diagnosis of osteoporosis was made always personally in 25.2% of cases. Personal diagnosis and follow-up, as well as actions directed to detection of osteoporosis were significantly higher among physicians working in centers with specific programs for osteoporosis. With regard to knowledge about osteoporosis, the mean percentage of correct responses was 63%. The percentage of correct responses was inversely associated with age and years of practice, and positively associated with speciality of community and family medicine. Primary care providers are in a good position to assess risk factors and recommend prevention strategies, as well as to play an active role in the diagnosis, care, and follow-up of patients with osteoporosis. Practitioners of younger age and relatively few years of practice were those with more up-to-date information regarding the disease, and the existence of a specific program for osteoporosis seems to improve the management of this condition.
KeywordsBone densitometry General practice Knowledge Medical education Osteoporosis Osteoporosis investigations Primary care physician
We thank Marta Pulido for editing the manuscript and for editorial assistance.
- 2.Grupo de Trabajo en Osteoporosis GTO (1992) Estudio de la densidad ósea de la población española. Madrid, EdimsaGoogle Scholar
- 3.Ciria M, Laiz A, Benito P (2000) Osteoporosis y grado de conocimiento de la misma en la población española. In: Estudio Episer (ed) Prevalencia e impacto de las enfermedades reumáticas en la población adulta española. Madrid, Sociedad Española de Reumatología (Spanish Society of Rheumatology), pp 101–124Google Scholar
- 5.Cannata JB, Naves ML, Virgós MJ, Gómez Alonso J, Díaz López JB (1993) Epidemiología de las fracturas vertebrales. Rev Esp Enf Metab Oseas 2[Suppl B]:2Google Scholar
- 7.Knobel H, Díez A, Arnau D, Alier A, Ibáñez J, Campodarve I et al (1992) Secuelas de la fractura osteoporótica de fémur en Barcelona. Med Clin (Barc) 98:441–444Google Scholar
- 14.Schrager S, Kausch T, Bobula JA (1999) Osteoporosis risk assessment by family practice faculty and residents: a chart review. WMJ 98:34–36Google Scholar