A pilot study of doctors beliefs and knowledge on corticosteroid-induced osteoporosis prevention: identifying barriers to improve practice

ABSTRACT Introduction: Despite the availability of effective treatments for the management of corticosteroid-induced osteoporosis (CIOP), the condition is under-treated. The aim of this pilot study was to identify key barriers to the use of preventive therapy in patients using long-term corticosteroids. Methods: A postal survey was sent to the 117 doctors in Heerenveen, northern Netherlands, to identify perceived barriers to the use of preventive therapy in patients taking corticosteroids and to assess knowledge and likely prescribing practices. Results: A response rate of 41% was achieved.Two key barriers identified were (i) a reluctance to prescribe preventive therapy in those patients already prescribed multiple medications and (ii) discontinuation of anti-resorptive medication. Only 76% of responding general practitioners (GPs) and 60% of specialists correctly answered that corticosteroids increase the risk of fracture independently of bone mineral density. In addition, only 33% of GPs and 50% of specialists correctly answered that a diagnosis of CIOP can only be made if the bone mineral density T-score is ¡Ü -2.5. Conclusions: Doctors did not identify many barriers to the prescribing of anti-resorptive therapies; however, there appears to be scope for improvement in their knowledge.