Preferences of GPs and patients for preventive osteoporosis drug treatment: a discrete-choice experiment.
BACKGROUND
Osteoporotic fractures have a serious economic impact on society and on the quality of life of patients. Differences in opinions on the desirability of preventive treatment initiation may hamper the process and outcome of shared decision making between physician and patient.


OBJECTIVE
To evaluate and compare preferences of GPs and patients for preventive osteoporosis drug treatment.


METHODS
Discrete-choice experiment (DCE) involving 34 general practices in the area of Rotterdam, the Netherlands. Participants included 40 GPs and 120 women aged > or = 60 years who participated in a study on osteoporosis case finding. We included any woman aged >60 years, with an over-representation of women with a high fracture risk (n = 60).


RESULTS
(i) The relative weights that GPs and patients place on five treatment attributes of preventive osteoporosis drug treatment: effectiveness, nausea as an adverse effect, total treatment duration, route of drug administration and out-of-pocket costs; and (ii) the determinants of any differences in preferences between GPs and patients.


RESULTS
The response rate was 40/59 (68%) for GPs and 120/181 (66%) for patients. All treatment attributes proved to be important for preferences of GPs and patients. GPs had a significantly less favourable attitude towards preventive osteoporosis drug treatment than patients; they placed significantly higher values on effectiveness of preventive drug treatment and short total preventive treatment duration than patients.


CONCLUSIONS
GPs and patients showed different preferences towards preventive osteoporosis drug treatment. Addressing each of these differences may have a positive effect on the process and outcomes of shared decision making regarding preventive treatment initiation.
Department of Public Health, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, the Netherlands. e.debekker@erasmusmc.nl
Esther W
EW
de Bekker-Grob
Marie-Louise
ML
Essink-Bot
Willem Jan
WJ
Meerding
Bart W
BW
Koes
Ewout W
EW
Steyerberg
D000284:Administration, Oral; D000368:Aged; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003625:Data Collection; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010024:Osteoporosis / Q000517:prevention & control*; D017060:Patient Satisfaction; D010361:Patients; D010821:Physicians, Family; D011795:Surveys and Questionnaires
D050071:Bone Density Conservation Agents