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., Wright, J., & 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
• Public URL: https://keele-repository.worktribe.com/output/485200
• Publisher URL: https://link.springer.com/article/10.1007/s00198-020-05696-3
• Additional Information: Abstract number; P1058, page; S524