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Published in: Archives of Osteoporosis 1-2/2012

01-12-2012 | Original Article

How do osteoporosis patients perceive their illness and treatment? Implications for clinical practice

Published in: Archives of Osteoporosis | Issue 1-2/2012

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Abstract

Summary

Non-adherence inhibits successful treatment of osteoporosis. This study used a theoretical framework to explore osteoporosis patients' cognitive and emotional representations of their illness and medication, using both interviews and drawing. We recorded some misconceptions patients have about their condition and medication which could act as barriers to treatment adherence.

Purpose

Despite the high efficacy of current treatments in reducing fracture risk, poor adherence is still a problem in osteoporosis. This qualitative study aims to inform the development of a psychological intervention to increase adherence through the investigation of osteoporosis patients' perceptions of their illness and medication. The self-regulation model (Leventhal) provided the framework for the study.

Method

Participants were 14 female outpatients from a London teaching hospital who suffer with osteoporosis or osteopenia. Data were collected using both semi-structured interviews and drawings. Drawings were used to elicit participants' visual representations (imagery) of their condition.

Results

We found that patients held illness and medication beliefs that were not in accord with current scientific evidence. Interviews revealed that participants had good knowledge of what osteoporosis is, but they had low understanding of the role of medication in reducing fracture risk, various concerns about the side effects of medication, poor understanding of the causes of osteoporosis and uncertainty about how it can be controlled. Additionally, drawings elicited more information about the perceived effects of osteoporosis and emotional reactions to the condition.

Conclusions

Osteoporosis sufferers need a better understanding of their fracture risk and what they can do to control their condition. Concerns about medication need to be addressed in order to improve adherence, particularly in relation to the management of side effects. Since drawings of osteoporosis were found to arouse emotions, it is concluded that risk communication in osteoporosis could benefit from using visual images.
Literature
1.
3.
go back to reference Gauthier A et al (2011) Epidemiological burden of postmenopausal osteoporosis in the UK from 2010 to 2021: estimations from a disease model. Arch Osteoporos 6(1):179–188PubMedCrossRef Gauthier A et al (2011) Epidemiological burden of postmenopausal osteoporosis in the UK from 2010 to 2021: estimations from a disease model. Arch Osteoporos 6(1):179–188PubMedCrossRef
4.
go back to reference Campbell M et al (2000) Framework for design and evaluation of complex interventions to improve health. BMJ 321:694–696PubMedCrossRef Campbell M et al (2000) Framework for design and evaluation of complex interventions to improve health. BMJ 321:694–696PubMedCrossRef
5.
go back to reference Haynes R et al (2002) Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev (2):CD000011 Haynes R et al (2002) Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev (2):CD000011
6.
go back to reference O'Donohue WT, Levensky ER (2006) Promoting treatment adherence: a practical handbook for health care providers. Sage Publications Inc, Thousand Oaks, p 458 O'Donohue WT, Levensky ER (2006) Promoting treatment adherence: a practical handbook for health care providers. Sage Publications Inc, Thousand Oaks, p 458
7.
go back to reference Siris ES et al (2006) Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 81(8):1013–1022PubMedCrossRef Siris ES et al (2006) Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc 81(8):1013–1022PubMedCrossRef
8.
go back to reference Gleeson T et al (2009) Interventions to improve adherence and persistence with osteoporosis medications: a systematic literature review. Osteoporos Int 20(12):2127–2134PubMedCrossRef Gleeson T et al (2009) Interventions to improve adherence and persistence with osteoporosis medications: a systematic literature review. Osteoporos Int 20(12):2127–2134PubMedCrossRef
9.
go back to reference Horne R et al (2005) Concordance, adherence and compliance in medicine taking. Report for the National Co-ordinating Centre for the NHS service delivery and organisation R & D (NCCSDO), pp 1–372 Horne R et al (2005) Concordance, adherence and compliance in medicine taking. Report for the National Co-ordinating Centre for the NHS service delivery and organisation R & D (NCCSDO), pp 1–372
10.
go back to reference Petrie K, Weinman J (eds) (1997) Perceptions of health and illness. Current research and applications. Harwood Academic Publishers, Singapore, pp 1–17, Introduction to the perceptions of health and illness Petrie K, Weinman J (eds) (1997) Perceptions of health and illness. Current research and applications. Harwood Academic Publishers, Singapore, pp 1–17, Introduction to the perceptions of health and illness
11.
go back to reference Carr A, Thompson P, Cooper C (2006) Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional survey. Osteoporos Int 17(11):1638–1644PubMedCrossRef Carr A, Thompson P, Cooper C (2006) Factors associated with adherence and persistence to bisphosphonate therapy in osteoporosis: a cross-sectional survey. Osteoporos Int 17(11):1638–1644PubMedCrossRef
12.
go back to reference McHorney CA et al (2007) The impact of osteoporosis medication beliefs and side-effect experiences on non-adherence to oral bisphosphonates. Curr Med Res Opin 23(12):3137–3152PubMedCrossRef McHorney CA et al (2007) The impact of osteoporosis medication beliefs and side-effect experiences on non-adherence to oral bisphosphonates. Curr Med Res Opin 23(12):3137–3152PubMedCrossRef
13.
go back to reference Giangregorio L et al (2008) Do patients perceive a link between a fragility fracture and osteoporosis? BMC Musculoskelet Disord 9(1):38PubMedCrossRef Giangregorio L et al (2008) Do patients perceive a link between a fragility fracture and osteoporosis? BMC Musculoskelet Disord 9(1):38PubMedCrossRef
14.
go back to reference Giangregorio L et al (2009) Osteoporosis risk perceptions among patients who have sustained a fragility fracture. Patient Educ Couns 74(2):213–220PubMedCrossRef Giangregorio L et al (2009) Osteoporosis risk perceptions among patients who have sustained a fragility fracture. Patient Educ Couns 74(2):213–220PubMedCrossRef
15.
go back to reference Leventhal H et al (1997) Illness representations: theoretical foundations. In: Petrie KJ, Weinman JA (eds) Perceptions of health and illness. Current research and applications. Harwood Academic, London, pp 19–45 Leventhal H et al (1997) Illness representations: theoretical foundations. In: Petrie KJ, Weinman JA (eds) Perceptions of health and illness. Current research and applications. Harwood Academic, London, pp 19–45
16.
go back to reference Horne R, Weinman J (1999) Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res 47(6):555–567PubMedCrossRef Horne R, Weinman J (1999) Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res 47(6):555–567PubMedCrossRef
17.
go back to reference Horne R (2003) Treatment perceptions and self regulation. In: Routledge (ed) The self regulation of health and illness behaviour. Taylor and Francis Group, London, pp 138–155 Horne R (2003) Treatment perceptions and self regulation. In: Routledge (ed) The self regulation of health and illness behaviour. Taylor and Francis Group, London, pp 138–155
18.
go back to reference Broadbent E, Donkin L, Stroh JC (2011) Illness and treatment perceptions are associated with adherence to medications, diet, and exercise in diabetic patients. Diabetes Care 34(2):338–340PubMedCrossRef Broadbent E, Donkin L, Stroh JC (2011) Illness and treatment perceptions are associated with adherence to medications, diet, and exercise in diabetic patients. Diabetes Care 34(2):338–340PubMedCrossRef
19.
go back to reference French DP, Cooper A, Weinman J (2006) Illness perceptions predict attendance at cardiac rehabilitation following acute myocardial infarction: a systematic review with meta-analysis. J Psychosom Res 61(6):757–767PubMedCrossRef French DP, Cooper A, Weinman J (2006) Illness perceptions predict attendance at cardiac rehabilitation following acute myocardial infarction: a systematic review with meta-analysis. J Psychosom Res 61(6):757–767PubMedCrossRef
20.
go back to reference Broadbent E et al (2006) Changes in patient drawings of the heart identify slow recovery after myocardial infarction. Psychosom Med 68(6):910–913PubMedCrossRef Broadbent E et al (2006) Changes in patient drawings of the heart identify slow recovery after myocardial infarction. Psychosom Med 68(6):910–913PubMedCrossRef
21.
go back to reference Harrow A et al (2008) Seeing is believing, and believing is seeing: an exploration of the meaning and impact of women's mental images of their breast cancer and their potential origins. Patient Educ Couns 73(2):339–346PubMedCrossRef Harrow A et al (2008) Seeing is believing, and believing is seeing: an exploration of the meaning and impact of women's mental images of their breast cancer and their potential origins. Patient Educ Couns 73(2):339–346PubMedCrossRef
22.
go back to reference Guillemin M (2004) Understanding illness: using drawings as a research method. Qual Health Res 14(2):272–289PubMedCrossRef Guillemin M (2004) Understanding illness: using drawings as a research method. Qual Health Res 14(2):272–289PubMedCrossRef
23.
go back to reference Ritchie J, Spencer L et al (2003) Carrying out qualitative analysis. Carrying out qualitative analysis in qualitative research in practice. Sage, London Ritchie J, Spencer L et al (2003) Carrying out qualitative analysis. Carrying out qualitative analysis in qualitative research in practice. Sage, London
24.
25.
go back to reference Baumann LJ et al (1989) Illness representations and matching labels with symptoms. Health Psychol 8(4):449–469PubMedCrossRef Baumann LJ et al (1989) Illness representations and matching labels with symptoms. Health Psychol 8(4):449–469PubMedCrossRef
26.
go back to reference French DP et al (2002) The structure of beliefs about the causes of heart attacks: a network analysis. Br J Health Psychol 7(Part 4):463–479PubMedCrossRef French DP et al (2002) The structure of beliefs about the causes of heart attacks: a network analysis. Br J Health Psychol 7(Part 4):463–479PubMedCrossRef
27.
go back to reference Lau E et al (2008) Patients' adherence to osteoporosis therapy: exploring the perceptions of postmenopausal women. Can Fam Physician 54(3):394–402PubMed Lau E et al (2008) Patients' adherence to osteoporosis therapy: exploring the perceptions of postmenopausal women. Can Fam Physician 54(3):394–402PubMed
28.
go back to reference Zolnierek KB, Dimatteo MR (2009) Physician communication and patient adherence to treatment: a meta-analysis. Med Care 47(8):826–834PubMedCrossRef Zolnierek KB, Dimatteo MR (2009) Physician communication and patient adherence to treatment: a meta-analysis. Med Care 47(8):826–834PubMedCrossRef
29.
go back to reference Witte K (1992) Putting the fear back into fear appeals: the extended parallel process model. Commun Monogr 59(4):329–349CrossRef Witte K (1992) Putting the fear back into fear appeals: the extended parallel process model. Commun Monogr 59(4):329–349CrossRef
Metadata
Title
How do osteoporosis patients perceive their illness and treatment? Implications for clinical practice
Publication date
01-12-2012
Published in
Archives of Osteoporosis / Issue 1-2/2012
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-012-0089-9

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