Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2022

01-12-2022 | Osteoporosis | Original Article

Screening and management of osteoporosis: a survey of knowledge, attitude and practice among primary care physicians in Malaysia

Authors: Chai Li Tay, Wei Leik Ng, Hooi Chin Beh, Wan Chieh Lim, Narwani Hussin

Published in: Archives of Osteoporosis | Issue 1/2022

Login to get access

Abstract

Summary

We surveyed primary care physicians in Malaysia for their knowledge, attitude and practice in screening and managing osteoporosis. We found a low level of screening and active management of osteoporosis in the primary care setting despite positive attitudes towards them. We advocate for the active management of osteoporosis at the primary care level.

Introduction

Prevention of osteoporotic fracture is important in primary healthcare for healthy ageing. Little is known about the knowledge, attitude, practice and barriers in the screening and managing osteoporosis among primary care doctors.

Methods

A cross-sectional study, using an online pre-tested questionnaire after face and content validation, was conducted for primary care doctors from 1 June to 30 July 2021 across Malaysia. Pearson’s chi-square test and logistic regression were employed.

Results

A total of 350 primary care doctors in Malaysia, consisting of 113 (32.3%) family medicine specialists (FMS) and 237 (67.7%) medical officers, participated in this study. The mean ± SD score of osteoporosis knowledge was 50.46 ± 15.09 with minimum and maximum values of 0 and 83.64%, respectively. One hundred and ten (31.4%) respondents achieved a satisfactory overall knowledge score of ≥ 60%, 156 (44.6%) were confident in advising patients for initiation of anti-osteoporotic medication, and 243 (69.4%) perceived that bisphosphonate should be made available in health clinics. Only 97 (27.7%) practised osteoporosis screening. Inaccessibility of bone mineral densitometry (BMD) (90.6%), inadequate knowledge (87.7%) and inaccessibility of pharmacotherapy (87.1%) are perceived modifiable barriers to osteoporosis screening and management. Factors associated with a satisfactory knowledge of osteoporosis are designation as a family medicine specialist (AOR 3.034, p = 0.002), attendance at an osteoporosis management update course (AOR 2.095, p = 0.034) and the practice of osteoporosis screening for the elderly (AOR 2.767, p = 0.001).

Conclusion

Given the insufficient knowledge and low level of osteoporosis screening, there is a need for a national structured health programme to address the knowledge gap, increase screening practices and enhance accessibility to BMD and anti-osteoporosis medication in primary care.
Literature
1.
NIH consensus development panel on osteoporosis prevention (2001) diagnosis, and therapy. JAMA 285(6):785–795CrossRef
2.
Ambrish Mithal PE (2013) Carey S Kyer, Charanjit K Jagait, Laura Misteli, Dominique Pierroz, The Asia-Pacific regional audit: epidemiology, costs & burden of osteoporosis in. Int Osteoporos Foundation 2013:19–20
3.
Downey C, Kelly M, Quinlan JF (2019) Changing trends in the mortality rate at 1-year post hip fracture - a systematic review. World J Orthop 10(3):166–175CrossRefPubMedPubMedCentral
4.
Vochteloo AJ et al (2013) More than half of hip fracture patients do not regain mobility in the first postoperative year. Geriatr Gerontol Int 13(2):334–341CrossRefPubMed
5.
Ballane G et al (2014) Secular trends in hip fractures worldwide: opposing trends east versus west. J Bone Miner Res 29(8):1745–1755CrossRefPubMed
6.
Cheung CL et al (2018) An updated hip fracture projection in Asia: the Asian Federation of Osteoporosis Societies study. Osteoporos Sarcopenia 4(1):16–21CrossRefPubMedPubMedCentral
7.
Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7(5):407–413CrossRefPubMed
8.
Harvey NC et al (2017) Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures. Osteoporos Int 28(5):1507–1529CrossRefPubMedPubMedCentral
9.
10.
Abdulameer SA, Sahib MN, Sulaiman SAS (2018) The prevalence of osteopenia and osteoporosis among Malaysian type 2 diabetic patients using quantitative ultrasound densitometer. Open Rheumatol J 12:50–64CrossRefPubMedPubMedCentral
11.
Leong J, Teh J, Zainodin A, Belani L, Ashraff M, Ariff M et al (2021) Osteoporosis care gap following fragility fracture in a tertiary teaching hospital. J Commu Med Publ Health Rep 2(4):1–5
12.
Yeap SS et al (2017) Trends in post osteoporotic hip fracture care from 2010 to 2014 in a private hospital in Malaysia. Osteoporos Sarcopenia 3(2):112–116CrossRefPubMedPubMedCentral
13.
Fogelman YGI, Segal E, Ish-Shalom S (2016) Managing osteoporosis: a survey of knowledge, attitudes and practices among primary care physicians in Israel. PLoS ONE 11(8):e0160661CrossRefPubMedPubMedCentral
14.
Ahmed Z et al (2019) Knowledge, attitude and practice towards osteoporosis among general practitioners working in Al Majmaah Province, KSA. Asian J Pharma Res Health Care 11(2–4):45–54CrossRef
15.
Bloom BS (1956) Taxonomy of educational objectives, handbook I: the cognitive domain. David McKay Co Inc., New York
16.
Chenot R et al (2007) German primary care doctors’ awareness of osteoporosis and knowledge of national guidelines. Exp Clin Endocrinol Diabetes 115(9):584–589CrossRefPubMed
17.
Jaglal SB, Carroll J, Hawker G, McIsaac WJ, Jaakkimainen L, Cadarette SM, Cameron C, Davis D (2003) How are family physicians managing osteoporosis? Qualitative study of their experiences and educational needs. Can Fam Physician 49:462–468PubMedPubMedCentral
18.
Otmar R, Reventlow SD, Nicholson GC, Kotowicz MA, Pasco JA (2012) General medical practitioners’ knowledge and beliefs about osteoporosis and its investigation and management. Arch Osteoporos 7:107–114CrossRefPubMed
19.
Perez-Edo L et al (2004) Management of osteoporosis in general practice: a cross-sectional survey of primary care practitioners in Spain. Osteoporos Int 15(3):252–257CrossRefPubMed
20.
Werner P, Vered I (2000) Management of osteoporosis: a survey of Israeli physicians’ knowledge and attitudes. Isr Med Assoc J 2(5):361–364PubMed
21.
22.
Leonard E et al (2019) Factors affecting health care provider knowledge and acceptance of biosimilar medicines: a systematic review. J Manag Care Spec Pharm 25(1):102–112PubMed
23.
Simonelli C et al (2002) Barriers to osteoporosis identification and treatment among primary care physicians and orthopedic surgeons. Mayo Clin proceed Mayo Clin 77:334–338CrossRef
24.
Davis SR et al (2011) Simplifying screening for osteoporosis in Australian primary care: the Prospective Screening for Osteoporosis; Australian Primary Care Evaluation of Clinical Tests (PROSPECT) study. Menopause 18(1):53–59CrossRefPubMed
25.
Chandran M et al (2020) Comparison of the osteoporosis self-assessment tool for Asians and the fracture risk assessment tool - FRAX to identify densitometric defined osteoporosis: a discriminatory value analysis in a multi-ethnic female population in Southeast Asia. Osteoporos Sarcopenia 6(2):53–58CrossRefPubMedPubMedCentral
26.
27.
28.
Toh LS et al (2019) A comparison of 6 osteoporosis risk assessment tools among postmenopausal women in Kuala Lumpur. Malaysia Osteoporos Sarcopenia 5(3):87–93CrossRefPubMed
29.
Martin-Sanchez M et al (2019) Cost-effectiveness of the screening for the primary prevention of fragility hip fracture in spain using FRAX((R)). Calcif Tissue Int 105(3):263–270CrossRefPubMed
30.
Turner DA et al (2018) The cost-effectiveness of screening in the community to reduce osteoporotic fractures in older women in the UK: economic evaluation of the SCOOP study. J Bone Miner Res 33(5):845–851CrossRefPubMed
31.
32.
33.
34.
Hand phone users survey (2018) 2018, Malaysian Communications and Multimedia Commission: Cyberjaya. Selangor, Malaysia
Metadata
Title
Screening and management of osteoporosis: a survey of knowledge, attitude and practice among primary care physicians in Malaysia
Authors
Chai Li Tay
Wei Leik Ng
Hooi Chin Beh
Wan Chieh Lim
Narwani Hussin
Publication date
01-12-2022
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-022-01111-y

Other articles of this Issue 1/2022

Archives of Osteoporosis 1/2022 Go to the issue

Original Article

Exploring the treatment gap among patients with osteoporosis-related fractures in France

Original Article

Inter-observer agreement of vertebral fracture assessment with dual-energy x-ray absorptiometry equipment

Original Article

One-year mortality after hip fracture surgery: urban–rural differences in the Colombian Andes

Review Article

Prevalence and treatment rate of osteoporosis in patients undergoing total knee and hip arthroplasty: a systematic review and meta-analysis

Correction

Correction to: Access to care for low trauma hip fractures in South Africa

Original Article

Access to care for low trauma hip fractures in South Africa