Osteoporosis International

, Volume 15, Issue 3, pp 252–257 | Cite as

Management of osteoporosis in general practice: a cross-sectional survey of primary care practitioners in Spain

  • L. Pérez-EdoEmail author
  • M. Ciria Recasens
  • C. Castelo-Branco
  • P. Orozco López
  • A. Gimeno Marqués
  • C. Pérez
  • J. Manasanch Dalmau
Original Article


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.


Bone densitometry General practice Knowledge Medical education Osteoporosis Osteoporosis investigations Primary care physician 



We thank Marta Pulido for editing the manuscript and for editorial assistance.


  1. 1.
    Riggs BL, Melton LJ 3rd (1986) Involutional osteoporosis. N Engl J Med 314:1676−86PubMedGoogle Scholar
  2. 2.
    Grupo de Trabajo en Osteoporosis GTO (1992) Estudio de la densidad ósea de la población española. Madrid, EdimsaGoogle Scholar
  3. 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
  4. 4.
    O’Neill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ and The European Vertebral Osteoporosis Study (1996) The prevalence of vertebral deformity in European men and women. J Bone Miner Res 11:1010–1018PubMedGoogle Scholar
  5. 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
  6. 6.
    Schott AM, Cormier C, Hans D, Favier F, Hausherr E, Dargent-Molina P et al (1998) How hip and whole-body mineral density predict hip fracture in elderly women: the EPIDOS Prospective Study. Osteoporos Int 8:247–254CrossRefPubMedGoogle Scholar
  7. 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
  8. 8.
    Ridout R, Hawker GA (2000) Use of bone densitometry by Ontario family physicians. Osteoporos Int 11:393–399CrossRefPubMedGoogle Scholar
  9. 9.
    Laroche M, Mazieres B and the Groupe Rhumatologique d’Etudes Cliniques de Midi-Pyrénées (1998) Does the French general practitioner correctly investigate and treat osteoporosis? Clin Rheumatol 17:139–143PubMedGoogle Scholar
  10. 10.
    Simonelli C, Killeen K, Mehle S, Swanson L (2002) Barriers to osteoporosis identification and treatment among primary care physicians and orthopedic surgeons. Mayo Clin Proc 77:334–338PubMedGoogle Scholar
  11. 11.
    Solomon DH, Connelly MT, Rosen CJ, Dawson-Hughes B, Kiel DP, Greenspan SL et al (2003) Factors related to the use of bone densitometry: survey responses of 494 primary care physicians in New England. Osteoporos Int 14:123–129PubMedGoogle Scholar
  12. 12.
    Taylor JC, Sterkel B, Utley M, Shipley M, Newman S, Horton M et al 2001) Opinions and experiences in general practice on osteoporosis prevention, diagnosis and management. Osteoporos Int 12:844–848CrossRefPubMedGoogle Scholar
  13. 13.
    Papa LJ, Weber BE (1997) Physician characteristics associated with the use of bone densitometry. J Gen Intern Med 12:781–783CrossRefPubMedGoogle Scholar
  14. 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
  15. 15.
    Suarez-Almazor M, Homik JE, Messina D, Davis P (1997) Attitudes and beliefs of family physicians and gynecologists in relation to the prevention and treatment of osteoporosis. J Bone Miner Res 12:1100–1107PubMedGoogle Scholar
  16. 16.
    Schrager S, Plane MB, Mundt MP, Stauffacher EA (2000) Osteoporosis prevention counseling during health maintenance examinations. J Fam Pract 49:1099–1103PubMedGoogle Scholar
  17. 17.
    Aragonés Fornés R, Orozco López P and Grupo de Osteoporosis de la Societat Catalana de Medicina Familiar i Comunitària (2002) Abordaje de la osteoporosis en atención primari en España (estudio ABOPAP-2000). Aten Primaria 30:350–356PubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • L. Pérez-Edo
    • 1
    Email author
  • M. Ciria Recasens
    • 1
  • C. Castelo-Branco
    • 2
  • P. Orozco López
    • 3
  • A. Gimeno Marqués
    • 4
  • C. Pérez
    • 1
  • J. Manasanch Dalmau
    • 5
  1. 1.Service of RheumatologyHospital de la EsperançaBarcelonaSpain
  2. 2.Hospital ClinicClinical Institute of Obstetrics and GynaecologyBarcelonaSpain
  3. 3.Area Bàsica de Salut (ABS) GóticBarcelonaSpain
  4. 4.Health Care Center l’AlcudiaValenciaSpain
  5. 5.Pierre Fabre IbéricaBarcelonaSpain

Personalised recommendations