Background/Purpose: Educating patients with osteoporosis about bone health could increase their knowledge and self-efficacy. These can help them adopt healthy lifestyles to prevent osteoporosis-associated fractures. To undertake an effective bone health education for these patients, it is necessary to determine what the gaps in knowledge are. This study synthetized the evidence on perceptions about osteoporosis.

Methods: A comprehensive search of the literature was done in an electronic database (Ovid – Medline) from 1946 to 2016, to identify qualitative studies exploring knowledge, beliefs and concerns of patients about osteoporosis and related terms. We included any study reporting detail data on literacy, understanding, perceptions and/or learning needs about bone health, low bone density, and osteoporosis. Major themes were identified and organized by categories.

Results: Ninety-three records were identified. Eight studies comprising 5 qualitative and 3 mixed-methods studies were included and underwent analysis. Population included 1,475 participants (including men and women), 18-90 years, 21% with confirmed osteoporosis. Major areas of knowledge deficits included: i) risk factors, ii) causes, iii) treatment, and iv) prevention. Two major categories were identified when patients were asked their beliefs about osteoporosis: i) osteoporosis is a disease of the old, frail with collapsed back and associated with weak bones and fractures; and ii) some thought it was very painful and could be caused by circumstances beyond one’s control and stressful life situations. Patients also reported that osteoporosis was not perceived as a serious illness such as stroke or cancer and that long term medication safety or efficacy was limited. There were four categories identified as concerns: i) diagnosis and treatment could be a source of worry (especially in the absence of symptoms); ii) patients may be “labeled” with the condition; iii) side effects and costs of osteoporosis medications, and iv) living with fractures.

Conclusion: Areas of knowledge deficit were risk factors, causes, treatment and prevention. The most common themes regarding patients’ beliefs across studies were that osteoporosis is a condition associated with weak bones and is painful. Medication side effects were of most concern to patients. This information can be used to tailor education, communication, and service initiatives to increase bone health knowledge and self-efficacy in osteoporosis patients and decrease fracture risk.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/knowledge-beliefs-and-concerns-about-osteoporosis-a-qualitative-synthesis/