title: Bone loss in epilepsy: barriers to prevention, diagnosis, and treatment.
abstract: In epilepsy populations there are multiple barriers to the prevention, diagnosis, and treatment of metabolic bone disease. This study explored issues that may be unique to inner-city care. We screened 101 consecutive patient charts from our clinic to identify barriers to optimal care. According to the Health Belief Model, when patients view a condition as not severe and their perceived susceptibility is low, they are unlikely to comply with screening and/or adopt preventative behaviors. Despite routine communications to primary care doctors regarding bone health, its importance is still overlooked. In addition, the managed care referral process makes it difficult for a specialist to prevent, screen, and treat a primary care condition with no symptoms. For optimal patient care and to stimulate prevention and screening compliance, a communication style adapted to the patient's knowledge, beliefs, and attitudes toward antiepileptic drug-induced bone loss is crucial to help reduce barriers against change.
authors.affiliation: Department of Neurology, Temple University School of Medicine, 3401 North Broad Street, 558 Parkinson Pavilion, Philadelphia, PA 19140, USA. John.Elliott@temple.edu
authors.forename: John O
authors.initials: JO
authors.lastname: Elliott
authors.forename: Mercedes P
authors.initials: MP
authors.lastname: Jacobson
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects*; D001294:Attitude to Health; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D012189:Retrospective Studies; D014505:Urban Population
chemical_list: D000927:Anticonvulsants; D050071:Bone Density Conservation Agents