ACCEPTABILITY OF BISPHOSPHONATE TREATMENT REGIMENS FOR OSTEOPOROSIS: A QUALITATIVE SYSTEMATIC REVIEW

Manning, F.; Paskins, Z.; Jinks, C.; Cotterell, E.; Sahota, O.; Bishop, S.; Wright, J.; Corp, N.

Abstract

Objective: To investigate the acceptability of different bisphosphonates treatment regimens for osteoporosis among patients and clinicians.

Methods: A systematic review of qualitative research exploring patients’ and clinicians’ views of the acceptability of bisphosphonates was conducted (PROSPERO [CRD42019143526]). Seven databases were searched. Article screening used eligibility criteria. Eligible full-text articles underwent data extraction and quality appraisal (CASP) by two independent reviewers. The Theoretical Framework of Acceptability (TFA) informed a framework analysis.

Results: 25 studies were included, the majority were conducted in North America or Europe, 12 studies explored patient views, 7 clinicians and 6 explored both. Only two studies mentioned intravenous bisphosphonates. Acceptability was described according to TFA domains of sense-making, emotions, opportunity costs, burden, perceived effectiveness and self efficacy. There were limited data relating the TFA domain of ethicality. Patients and clinicians made sense of bisphosphonates by considering a risk-benefit analysis, informed by perceived-need balanced against concerns and fears. Both need and concern changed over time and were influenced by the doctor-patient relationship, personal and vicarious experience and competing priorities. Patients and clinicians wanted evidence of effectiveness and expressed uncertainty about how treatment worked. Patients’ self-efficacy was enhanced by routinisation (e.g., weekly tablet taken whilst reading the Sunday paper).

Conclusion: By utilising the TFA, the findings demonstrate that a whole system, theoretically informed approach is necessary to both understand and improve acceptability. Additionally, there is a need to clarify what constitutes bisphosphonate treatment success and a need to explore views of patients receiving IV bisphosphonates.

Citation

Manning, F., Paskins, Z., Jinks, C., Cotterell, E., Sahota, O., Bishop, S., …Corp, N. (2021, August). ACCEPTABILITY OF BISPHOSPHONATE TREATMENT REGIMENS FOR OSTEOPOROSIS: A QUALITATIVE SYSTEMATIC REVIEW. Poster presented at World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2020)

• Presentation Conference Type: Poster
• Conference Name: World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO-IOF-ESCEO 2020)
• Start Date: Aug 20, 2021
• End Date: Aug 22, 2021
• Deposit Date: Jun 19, 2023
• Publisher URL: https://link.springer.com/article/10.1007/s00198-020-05696-3
• Additional Information: Abstract number; P1058, page; S524