Bone loss in epilepsy: barriers to prevention, diagnosis, and treatment.
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.
Elliott
John O
JO
Department of Neurology, Temple University School of Medicine, 3401 North Broad Street, 558 Parkinson Pavilion, Philadelphia, PA 19140, USA. John.Elliott@temple.edu
Jacobson
Mercedes P
MP
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
D000927:Anticonvulsants; D050071:Bone Density Conservation Agents