Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women
Osteoporosis is a prevalent condition among postmenopausal women, significantly increasing the risk of fragility fractures. Despite the availability of clinical guidelines, their implementation in primary care, remains highly variable, particularly regarding fracture prevention and shared decision-m...
| Autores: | , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universitat Autònoma de Barcelona |
| Repositorio: | Dipòsit Digital de Documents de la UAB |
| Idioma: | inglés |
| OAI Identifier: | oai:ddd.uab.cat:319826 |
| Acceso en línea: | https://ddd.uab.cat/record/319826 https://dx.doi.org/urn:doi:10.1186/s12875-025-02966-z |
| Access Level: | acceso abierto |
| Palabra clave: | Osteoporosis Fragility fractures Primary prevention Primary healthcare Shared decision-making |
| id |
ES_4df5ba25e5ff525bb44ebca45fa88fd3 |
|---|---|
| oai_identifier_str |
oai:ddd.uab.cat:319826 |
| network_acronym_str |
ES |
| network_name_str |
España |
| repository_id_str |
|
| spelling |
Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal womena qualitative study in SpainLeón-García, Montserrat|||0000-0001-8567-4685Cánovas Martínez, Esther|||0000-0001-7351-9389Álvarez Pérez, YolandaPou, María AntoniaLópez García-Franco, AlbertoSanz Bas, AnaRodriguez-Moreno, SaraDelgado Espinoza, Claudia Erika|||0009-0009-9089-4784Roca, Pablo|||0000-0001-9815-4902González Osuna, Aránzazu|||0000-0002-2436-9035Fernández Valverde, Diana Elisabeth|||0000-0002-4665-729XMarín Nanco, Betzabeth|||0000-0002-2446-8391Medina-Aedo, Melixa|||0000-0002-9922-464XPerestelo-Pérez, Lilisbeth|||0000-0002-6113-7313Alonso-Coello, Pablo|||0000-0002-8001-8504OsteoporosisFragility fracturesPrimary preventionPrimary healthcareShared decision-makingOsteoporosis is a prevalent condition among postmenopausal women, significantly increasing the risk of fragility fractures. Despite the availability of clinical guidelines, their implementation in primary care, remains highly variable, particularly regarding fracture prevention and shared decision-making (SDM). We conducted a qualitative study to explore the attitudes and practices of Spanish family physicians in preventing fractures among postmenopausal women. Sixteen semi-structured interviews were conducted with physicians from diverse socioeconomic backgrounds and levels of clinical experience. Data were analysed using an iterative, theory-driven approach to identify key themes and barriers. Physicians showed substantial variability in fracture risk assessment approaches, frequently combining tools such as FRAX with clinical judgment. Most were cautious about prescribing bisphosphonates for primary prevention, citing concerns about the strength of the evidence and potential adverse effects. While non-pharmacological strategies, such as lifestyle modifications and fall prevention, were emphasized, their implementation was often constrained by workload pressures. Patient involvement in decision-making was hindered by widespread misconceptions about osteoporosis and its treatment, as well as the lack of appropriate decision-support tools. Participants highlighted the need for clearer guidelines, enhanced educational resources, and accessible decision aids to facilitate patient engagement in care. This study highlights the complex challenges family physicians face in fracture prevention among postmenopausal women, including heterogeneity of recommendations in guidelines, limited SDM implementation, and systemic barriers within primary care. Addressing these issues will require multifaceted interventions targeting both healthcare system constraints and patient education. Future efforts should focus on developing and implementing strategies that support evidence-based, patient-centred decision-making while accounting for the realities of primary care practice. 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/319826https://dx.doi.org/urn:doi:10.1186/s12875-025-02966-zreponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengInstituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI20/00681open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3198262026-06-06T12:50:31Z |
| dc.title.none.fl_str_mv |
Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women a qualitative study in Spain |
| title |
Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women |
| spellingShingle |
Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women León-García, Montserrat|||0000-0001-8567-4685 Osteoporosis Fragility fractures Primary prevention Primary healthcare Shared decision-making |
| title_short |
Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women |
| title_full |
Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women |
| title_fullStr |
Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women |
| title_full_unstemmed |
Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women |
| title_sort |
Family physicians' attitudes and practice on screening and prevention of fragility fractures, and shared decision-making with postmenopausal women |
| dc.creator.none.fl_str_mv |
León-García, Montserrat|||0000-0001-8567-4685 Cánovas Martínez, Esther|||0000-0001-7351-9389 Álvarez Pérez, Yolanda Pou, María Antonia López García-Franco, Alberto Sanz Bas, Ana Rodriguez-Moreno, Sara Delgado Espinoza, Claudia Erika|||0009-0009-9089-4784 Roca, Pablo|||0000-0001-9815-4902 González Osuna, Aránzazu|||0000-0002-2436-9035 Fernández Valverde, Diana Elisabeth|||0000-0002-4665-729X Marín Nanco, Betzabeth|||0000-0002-2446-8391 Medina-Aedo, Melixa|||0000-0002-9922-464X Perestelo-Pérez, Lilisbeth|||0000-0002-6113-7313 Alonso-Coello, Pablo|||0000-0002-8001-8504 |
| author |
León-García, Montserrat|||0000-0001-8567-4685 |
| author_facet |
León-García, Montserrat|||0000-0001-8567-4685 Cánovas Martínez, Esther|||0000-0001-7351-9389 Álvarez Pérez, Yolanda Pou, María Antonia López García-Franco, Alberto Sanz Bas, Ana Rodriguez-Moreno, Sara Delgado Espinoza, Claudia Erika|||0009-0009-9089-4784 Roca, Pablo|||0000-0001-9815-4902 González Osuna, Aránzazu|||0000-0002-2436-9035 Fernández Valverde, Diana Elisabeth|||0000-0002-4665-729X Marín Nanco, Betzabeth|||0000-0002-2446-8391 Medina-Aedo, Melixa|||0000-0002-9922-464X Perestelo-Pérez, Lilisbeth|||0000-0002-6113-7313 Alonso-Coello, Pablo|||0000-0002-8001-8504 |
| author_role |
author |
| author2 |
Cánovas Martínez, Esther|||0000-0001-7351-9389 Álvarez Pérez, Yolanda Pou, María Antonia López García-Franco, Alberto Sanz Bas, Ana Rodriguez-Moreno, Sara Delgado Espinoza, Claudia Erika|||0009-0009-9089-4784 Roca, Pablo|||0000-0001-9815-4902 González Osuna, Aránzazu|||0000-0002-2436-9035 Fernández Valverde, Diana Elisabeth|||0000-0002-4665-729X Marín Nanco, Betzabeth|||0000-0002-2446-8391 Medina-Aedo, Melixa|||0000-0002-9922-464X Perestelo-Pérez, Lilisbeth|||0000-0002-6113-7313 Alonso-Coello, Pablo|||0000-0002-8001-8504 |
| author2_role |
author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Osteoporosis Fragility fractures Primary prevention Primary healthcare Shared decision-making |
| topic |
Osteoporosis Fragility fractures Primary prevention Primary healthcare Shared decision-making |
| description |
Osteoporosis is a prevalent condition among postmenopausal women, significantly increasing the risk of fragility fractures. Despite the availability of clinical guidelines, their implementation in primary care, remains highly variable, particularly regarding fracture prevention and shared decision-making (SDM). We conducted a qualitative study to explore the attitudes and practices of Spanish family physicians in preventing fractures among postmenopausal women. Sixteen semi-structured interviews were conducted with physicians from diverse socioeconomic backgrounds and levels of clinical experience. Data were analysed using an iterative, theory-driven approach to identify key themes and barriers. Physicians showed substantial variability in fracture risk assessment approaches, frequently combining tools such as FRAX with clinical judgment. Most were cautious about prescribing bisphosphonates for primary prevention, citing concerns about the strength of the evidence and potential adverse effects. While non-pharmacological strategies, such as lifestyle modifications and fall prevention, were emphasized, their implementation was often constrained by workload pressures. Patient involvement in decision-making was hindered by widespread misconceptions about osteoporosis and its treatment, as well as the lack of appropriate decision-support tools. Participants highlighted the need for clearer guidelines, enhanced educational resources, and accessible decision aids to facilitate patient engagement in care. This study highlights the complex challenges family physicians face in fracture prevention among postmenopausal women, including heterogeneity of recommendations in guidelines, limited SDM implementation, and systemic barriers within primary care. Addressing these issues will require multifaceted interventions targeting both healthcare system constraints and patient education. Future efforts should focus on developing and implementing strategies that support evidence-based, patient-centred decision-making while accounting for the realities of primary care practice. |
| publishDate |
2025 |
| dc.date.none.fl_str_mv |
2 2025-01-01 2025 2025-01-01 |
| dc.type.none.fl_str_mv |
Article http://purl.org/coar/resource_type/c_6501 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
https://ddd.uab.cat/record/319826 https://dx.doi.org/urn:doi:10.1186/s12875-025-02966-z |
| url |
https://ddd.uab.cat/record/319826 https://dx.doi.org/urn:doi:10.1186/s12875-025-02966-z |
| dc.language.none.fl_str_mv |
Inglés eng |
| language_invalid_str_mv |
Inglés |
| language |
eng |
| dc.relation.none.fl_str_mv |
Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI20/00681 |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| dc.rights.openaire.fl_str_mv |
info:eu-repo/semantics/openAccess |
| rights_invalid_str_mv |
open access http://purl.org/coar/access_right/c_abf2 https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| eu_rights_str_mv |
openAccess |
| dc.format.none.fl_str_mv |
application/pdf |
| dc.source.none.fl_str_mv |
reponame:Dipòsit Digital de Documents de la UAB instname:Universitat Autònoma de Barcelona |
| instname_str |
Universitat Autònoma de Barcelona |
| reponame_str |
Dipòsit Digital de Documents de la UAB |
| collection |
Dipòsit Digital de Documents de la UAB |
| repository.name.fl_str_mv |
|
| repository.mail.fl_str_mv |
|
| _version_ |
1869407725979435008 |
| score |
15,811543 |