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Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2023

Open Access 01-12-2023 | Osteoporosis | Original Article

Bone health in rural Australia: a mixed methods study of consumer needs

Authors: Alicia R Jones, Belinda Garth, Catherine Haigh, Peter R Ebeling, Helena Teede, Amanda J Vincent

Published in: Archives of Osteoporosis | Issue 1/2023

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Abstract

Summary

This mixed methods study explores osteoporosis among adults living in a regional area of Victoria, Australia. Three major themes emerged from interviews, which reflected the findings of surveys, concerns regarding the adequacy of care in rural areas, a desire for tailored, local care, and a desire for hybrid telemedicine or in-person services.

Purpose

Osteoporosis or osteopenia affects over half of adults aged over 50 years. People living outside major cities in Australia have higher hip fracture rates than people living in cities, along with reduced access to bone densitometry and osteoporosis specialists. This study explores osteoporosis risk factors, knowledge, experiences of and preferences for care in people living in a regional area, to inform development of osteoporosis care programs.

Methods

Adults living in a large non-metropolitan region of Australia were invited to participate in a mixed methods study: a survey (phase 1) followed by semi-structured interviews (phase 2) with triangulation of results. Data collected included osteoporosis diagnosis, risk factors, management, knowledge, preferences for care and experience using telemedicine. Surveys were analysed quantitatively, with linear and logistic regression used to assess factors related to osteoporosis knowledge or satisfaction with telemedicine. Interview transcripts were analysed using thematic analysis by two researchers, with in-depth discussion to identify themes.

Results

Sixty-two participants completed the survey, and 15 completed interviews. The mean (SD) age of survey participants was 62.2 (14.1) years, 57% had a screening test for osteoporosis, and 12 (19%) had a diagnosis of osteoporosis. The mean osteoporosis knowledge score was 8.4 / 19 and did not differ with age, education, or history of osteoporosis. The majority wanted access to more information about osteoporosis but preferred method differed, and the majority preferred in-person medical consultations to telemedicine. Interview participants were aged between 57 and 87 years, and included 8 with osteoporosis or osteopenia. Three major themes emerged: concerns regarding the adequacy of care in rural areas, a desire for tailored local car and a desire for hybrid telemedicine or in-person services.

Conclusion

Gaps exist in rural osteoporosis care, including knowledge, screening and management. People have differing experiences of care, access to services and preferences for care. High-quality care, tailored to their needs, was preferred. Improving osteoporosis services for regional Australia will require a flexible, multi-faceted approach, addressing needs of the local community and providers.
Appendix
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Literature
1.
Wright NC, Looker AC, Saag KG et al (2014) The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res 29(11):2520–2526CrossRefPubMed
2.
Watts JJ, Abimanyi-Ochom J, Sanders KM (2013) Osteoporosis costing all Australians a new burden of disease analysis – 2012 to 2022. Melbourne, Vic, Osteoporosis Australia
3.
4.
Kanis JA, Norton N, Harvey NC et al (2021) SCOPE 2021: a new scorecard for osteoporosis in Europe. Arch Osteoporosis 16(1):82CrossRef
5.
Australian Commission on Safety and Quality in Health Care and National Performance Authority. Australian Atlas of Healthcare Variation. Sydney: ACSQHC, 2015
6.
Lai MMY, Ang WM, McGuiness M, Larke AB (2012) Undertreatment of osteoporosis in regional Western Australia. Australas J Ageing 31(2):110–114CrossRefPubMed
7.
Macgregor CB, Meerkin JD, Alley SJ et al (2018) Osteoporosis and low bone mineral density (osteopenia) in rural and remote Queensland. Aust J Rural Health 26(5):369–374CrossRefPubMed
8.
Ewald DP, Eisman JA, Ewald BD et al (2009) Population rates of bone densitometry use in Australia, 2001-2005, by sex and rural versus urban location. Med J Aust 190(3):126–128CrossRefPubMed
9.
Brennan SL, Pasco JA, Urquhart DM et al (2010) The association between urban or rural locality and hip fracture in community-based adults: a systematic review. J Epidemiol Community Health 64(8):656–665CrossRefPubMed
10.
Singh GK, Siahpush M (2014) Widening rural-urban disparities in life expectancy, U.S., 1969-2009. Am J Prev Med 46(2):e19–e29CrossRefPubMed
11.
12.
Jones AR, Goh M, Langham R et al (2020) Osteoporosis and premature ovarian insufficiency: geographic variation in clinicians’ and consumers’ knowledge gaps and barriers to care. Arch Osteoporosis 15(1):38CrossRef
13.
Australian Government Department of Health. National Strategic Action Plan for Osteoporosis. Canberra, ACT: Commonwealth of Australia; 2019
14.
Seidler E, Keshaviah A, Brown C et al (2014) Geographic distribution of clinical trials may lead to inequities in access. Clin Invest 4(4):373–380CrossRef
15.
16.
Jones AR, Tay CT, Melder A et al (2020) What are models of care? A systematic search and narrative review to guide development of care models for premature ovarian insufficiency. Semin Reprod Med 38(4-05):323–330PubMed
17.
Winter SS, Page-Reeves JM, Page KA et al (2018) Inclusion of special populations in clinical research: important considerations and guidelines. J Clin Transl Res 4(1):56–69PubMedPubMedCentral
18.
19.
Winzenberg TM, Oldenburg B, Frendin S, Jones G (2003) The design of a valid and reliable questionnaire to measure osteoporosis knowledge in women: the Osteoporosis Knowledge Assessment Tool (OKAT). BMC Musculoskelet Disord 4(1):17CrossRefPubMedPubMedCentral
20.
The Royal Australian College of General Practitioners and Osteoporosis Australia (2017) Osteoporosis prevention, diagnosis and management in postmenopausal women and men over 50 years of age, 2nd edn. RACGP, East Melbourne, Vic
21.
Harris PA, Taylor R, Minor BL et al (2019) The REDCap consortium: building an international community of software platform partners. J Biomed Inform 95:103208CrossRefPubMedPubMedCentral
22.
Harris PA, Taylor R, Thielke R et al (2009) Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381CrossRefPubMed
23.
Palcu P, Munce S, Jaglal SB et al (2020) Understanding patient experiences and challenges to osteoporosis care delivered virtually by telemedicine: a mixed methods study. Osteoporos Int 31(2):351–361CrossRefPubMed
24.
Donelan K, Barreto EA, Sossong S et al (2019) Patient and clinician experiences with telehealth for patient follow-up care. Am J Manag Care 25(1):40–44PubMed
25.
Beauvais C, Poivret D, Lespessailles E et al (2019) Understanding patients’ perspectives and educational needs by type of osteoporosis in men and women and people with glucocorticosteroid-induced osteoporosis: a qualitative study to improve disease management. Calcif Tissue Int 105(6):589–608CrossRefPubMed
26.
Braun V, Clarke V (2021) Thematic analysis. In: Lyons E, Coyle A (eds) Analysing qualitative data in psychology, 3rd edn. Sage, United Kingdom, pp 128–147
27.
Braun V, Clarke V (2021) To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qual Res Sport Exerc Health 13(2):201–216CrossRef
28.
Malterud K, Siersma VD, Guassora AD (2015) Sample size in qualitative interview studies: guided by information power. Qual Health Res 26(13):1753–1760CrossRef
29.
Cehic M, Lerner RG, Achten J et al (2019) Prescribing and adherence to bone protection medications following hip fracture in the United Kingdom: results from the World Hip Trauma Evaluation (WHiTE) cohort study. Bone Jt J 101-B(11):1402–1407CrossRef
30.
Barton DW, Behrend CJ, Carmouche JJ (2019) Rates of osteoporosis screening and treatment following vertebral fracture. Spine J 19(3):411–417CrossRefPubMed
31.
Jones AR, Herath M, Ebeling PR et al (2021) Models of care for osteoporosis: a systematic scoping review of efficacy and implementation characteristics. eClinicalMedicine 38:101022CrossRefPubMedPubMedCentral
32.
English S, Coyle L, Bradley S et al (2021) Virtual fracture liaison clinics in the COVID era: an initiative to maintain fracture prevention services during the pandemic associated with positive patient experience. Osteoporos Int 32(6):1221–1226CrossRefPubMedPubMedCentral
33.
Naik-Panvelkar P, Norman S, Elgebaly Z et al (2020) Osteoporosis management in Australian general practice: an analysis of current osteoporosis treatment patterns and gaps in practice. BMC Fam Pract 21(1):32CrossRefPubMedPubMedCentral
34.
Tzortziou Brown V, Underwood M, Mohamed N et al (2016) Professional interventions for general practitioners on the management of musculoskeletal conditions. Cochrane Database Syst Rev 2016(5):CD007495
35.
36.
Lewiecki EM, Rochelle R, Bouchonville MF et al (2017) Leveraging scarce resources with bone health TeleECHO to improve the care of osteoporosis. J Endocr Soc 1(12):1428–1434CrossRefPubMedPubMedCentral
37.
Matthews HL, Laya M, DeWitt DE (2006) Rural women and osteoporosis: awareness and educational needs. J Rural Health 22(3):279–283CrossRefPubMed
38.
Jakobsen PR, Hermann AP, Sondergaard J et al (2018) Left in limbo - Experiences and needs among postmenopausal women newly diagnosed with osteoporosis without preceding osteoporotic fractures: a qualitative study. Post Reprod Health 24(1):26–33CrossRefPubMed
39.
Coster S, Li Y, Norman IJ (2020) Cochrane reviews of educational and self-management interventions to guide nursing practice: a review. Int J Nurs Stud 110:103698CrossRefPubMed
40.
Krontoft A (2021) How do patients prefer to receive patient education material about treatment, diagnosis and procedures? —A survey study of patients preferences regarding forms of patient education materials; Leaflets, Podcasts, and Video. Open J Nurs 11(10):809–827CrossRef
41.
42.
Dunbar JA (2020) Worse than a low-income country: broadband access in rural and remote Australia. Aust J Rural Health 28(2):185CrossRefPubMed
43.
Jones AR, Ebeling PR, Teede H et al (2021) Patient experience of telemedicine for osteoporosis care during the COVID-19 pandemic. Clin Endocrinol 98(1):134–135CrossRef
44.
Vimalananda VG, Brito JP, Eiland LA et al (2022) Appropriate use of telehealth visits in endocrinology: policy perspective of the endocrine society. J Clin Endocrinol Metab 107(11):2953–2962CrossRefPubMedPubMedCentral
45.
Metadata
Title
Bone health in rural Australia: a mixed methods study of consumer needs
Authors
Alicia R Jones
Belinda Garth
Catherine Haigh
Peter R Ebeling
Helena Teede
Amanda J Vincent
Publication date
01-12-2023
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2023
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-023-01333-8

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