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Original Article

Primary Care House Staff Attitudes Toward Osteoporosis Management

Terry A. McNearney, MD, Angela J. Shepherd, MD, Ajoy Chhabra, MD, Niti Goel, MD
Volume: 99 Issue: 5 May, 2006

Abstract:

Objective: This study assessed possible institutional and patient-related factors influencing the delivery of postmenopausal osteoporosis (PMO) care and the diagnostic priority placed on addressing PMO, relative to other common medical conditions, by primary care house staff at our institution.


Methods: A questionnaire was designed and distributed to eligible house staff at our institution.


Results: Approximately 50% (n = 52) of the house staff participated. The supervising clinic attending, patients' lack of insurance, accessibility to medical care, comorbid conditions, and university formulary were reported to influence decisions regarding osteoporosis care. Osteoporosis was ranked 6th of 7 medical issues (hypertension, coronary artery disease, diabetes, hypercholesterolemia, adult immunizations, osteoporosis, thyroid disease) to address during a comprehensive medical visit.


Conclusions: Our institution's primary care house staff reported multiple influences on decision making regarding osteoporosis care, and an overall low priority to address this issue. Based on PMO's associated morbidity and mortality, primary care training programs are challenged to put resources toward optimizing house staff delivery of osteoporosis care.


Key Points


* Multiple institutional and patient-related factors were reported to influence house staff decision-making regarding the delivery of osteoporosis care to their patients.


* Addressing postmenopausal osteoporosis at the initial or comprehensive visit relative to 6 other common medical conditions was given a low priority by primary care house staff.


* Based on the morbidity and mortality associated with postmenopausal osteoporosis, various institutional and socioeconomic factors should be modified to optimize decision making and treatment plans of physicians-in-training.

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