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Understanding fragility fracture patients’ decision-making process regarding bisphosphonate treatment
SUMMARY: We aimed to understand how patients 50 years and older decided to persist with or stop osteoporosis (OP) treatment. Processes related to persisting with or stopping OP treatments are complex and dynamic. The severity and risks and harms related to untreated clinical OP and the favorable ben...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer London
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206259/ https://www.ncbi.nlm.nih.gov/pubmed/27423660 http://dx.doi.org/10.1007/s00198-016-3693-5 |
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author | Wozniak, L. A. Johnson, J. A. McAlister, F. A. Beaupre, L. A. Bellerose, D. Rowe, B. H. Majumdar, S. R. |
author_facet | Wozniak, L. A. Johnson, J. A. McAlister, F. A. Beaupre, L. A. Bellerose, D. Rowe, B. H. Majumdar, S. R. |
author_sort | Wozniak, L. A. |
collection | PubMed |
description | SUMMARY: We aimed to understand how patients 50 years and older decided to persist with or stop osteoporosis (OP) treatment. Processes related to persisting with or stopping OP treatments are complex and dynamic. The severity and risks and harms related to untreated clinical OP and the favorable benefit-to-risk profile for OP treatments should be reinforced. INTRODUCTION: Older adults with fragility fracture and clinical OP are at high risk of recurrent fracture, and treatment reduces this risk by 50 %. However, only 20 % of fracture patients are treated for OP and half stop treatment within 1 year. We aimed to understand how older patients with new fractures decided to persist with or stop OP treatment over 1 year. METHODS: We conducted a grounded theory study of patients 50 years and older with upper extremity fracture who started bisphosphonates and then reported persisting with or stopping treatment at 1 year. We used theoretical sampling to identify patients who could inform emerging concepts until data saturation was achieved and analyzed these data using constant comparison. RESULTS: We conducted 21 interviews with 12 patients. Three major themes emerged. First, patients perceived OP was not a serious health condition and considered its impact negligible. Second, persisters and stoppers differed in weighting the risks vs benefits of treatments, where persisters perceived less risk and more benefit. Persisters considered treatment “required” while stoppers often deemed treatment “optional.” Third, patients could change treatment status even 1-year post-fracture because they re-evaluated severity and impact of OP vs risks and benefits of treatments over time. CONCLUSIONS: The processes and reasoning related to persisting with or stopping OP treatments post-fracture are complex and dynamic. Our findings suggest two areas of leverage for healthcare providers to reinforce to improve persistence: (1) the severity and risks and harms related to untreated clinical OP and (2) the favorable benefit-to-risk profile for OP treatments. |
format | Online Article Text |
id | pubmed-5206259 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer London |
record_format | MEDLINE/PubMed |
spelling | pubmed-52062592017-01-18 Understanding fragility fracture patients’ decision-making process regarding bisphosphonate treatment Wozniak, L. A. Johnson, J. A. McAlister, F. A. Beaupre, L. A. Bellerose, D. Rowe, B. H. Majumdar, S. R. Osteoporos Int Original Article SUMMARY: We aimed to understand how patients 50 years and older decided to persist with or stop osteoporosis (OP) treatment. Processes related to persisting with or stopping OP treatments are complex and dynamic. The severity and risks and harms related to untreated clinical OP and the favorable benefit-to-risk profile for OP treatments should be reinforced. INTRODUCTION: Older adults with fragility fracture and clinical OP are at high risk of recurrent fracture, and treatment reduces this risk by 50 %. However, only 20 % of fracture patients are treated for OP and half stop treatment within 1 year. We aimed to understand how older patients with new fractures decided to persist with or stop OP treatment over 1 year. METHODS: We conducted a grounded theory study of patients 50 years and older with upper extremity fracture who started bisphosphonates and then reported persisting with or stopping treatment at 1 year. We used theoretical sampling to identify patients who could inform emerging concepts until data saturation was achieved and analyzed these data using constant comparison. RESULTS: We conducted 21 interviews with 12 patients. Three major themes emerged. First, patients perceived OP was not a serious health condition and considered its impact negligible. Second, persisters and stoppers differed in weighting the risks vs benefits of treatments, where persisters perceived less risk and more benefit. Persisters considered treatment “required” while stoppers often deemed treatment “optional.” Third, patients could change treatment status even 1-year post-fracture because they re-evaluated severity and impact of OP vs risks and benefits of treatments over time. CONCLUSIONS: The processes and reasoning related to persisting with or stopping OP treatments post-fracture are complex and dynamic. Our findings suggest two areas of leverage for healthcare providers to reinforce to improve persistence: (1) the severity and risks and harms related to untreated clinical OP and (2) the favorable benefit-to-risk profile for OP treatments. Springer London 2016-07-16 2017 /pmc/articles/PMC5206259/ /pubmed/27423660 http://dx.doi.org/10.1007/s00198-016-3693-5 Text en © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Wozniak, L. A. Johnson, J. A. McAlister, F. A. Beaupre, L. A. Bellerose, D. Rowe, B. H. Majumdar, S. R. Understanding fragility fracture patients’ decision-making process regarding bisphosphonate treatment |
title | Understanding fragility fracture patients’ decision-making process regarding bisphosphonate treatment |
title_full | Understanding fragility fracture patients’ decision-making process regarding bisphosphonate treatment |
title_fullStr | Understanding fragility fracture patients’ decision-making process regarding bisphosphonate treatment |
title_full_unstemmed | Understanding fragility fracture patients’ decision-making process regarding bisphosphonate treatment |
title_short | Understanding fragility fracture patients’ decision-making process regarding bisphosphonate treatment |
title_sort | understanding fragility fracture patients’ decision-making process regarding bisphosphonate treatment |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206259/ https://www.ncbi.nlm.nih.gov/pubmed/27423660 http://dx.doi.org/10.1007/s00198-016-3693-5 |
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