title: Managing Osteoporosis: A Survey of Knowledge, Attitudes and Practices among Primary Care Physicians in Israel.
abstract: BACKGROUND
  Osteoporosis is a systemic skeletal disorder characterized by impaired bone quality and microstructural deterioration leading to an increased propensity to fractures. This is a major health problem for older adults, which comprise an increasingly greater proportion of the general population. Due to a large number of patients and the insufficient availability of specialists in Israel and worldwide, osteoporosis is treated in large part by primary care physicians. We assessed the knowledge of primary care physicians on the diagnosis and treatment of osteoporosis.
  
  
  METHODS
  Physician's knowledge, sources of knowledge acquisition and self-evaluation of knowledge were assessed using a multiple choice questionnaire. Professional and demographic characteristics were assessed as well.
  
  
  RESULTS
  Of 490 physicians attending a conference, 363 filled the questionnaires (74% response rate). The physicians demonstrated better expertise in diagnosis than in medications (mechanism of action, side effects or contra-indications) but less than for other treatment related decisions. Overall, 50% demonstrated adequate knowledge of calcium and vitamin D supplementation, 51% were aware of the main therapeutic purpose of osteoporosis pharmacotherapy and 3% were aware that bisphosphonates should be avoided in patients with impaired renal function. Respondents stated frontal lectures at meetings as their main source of information on the subject.
  
  
  CONCLUSIONS
  The study indicates the need to intensify efforts to improve the knowledge of primary care physicians regarding osteoporosis, in general; and osteoporosis pharmacotherapy, in particular.
authors: Department of Family Practice, Leumit Health Services Tel aviv, Israel.|The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors: Yacov
authors: http://orcid.org/0000-0003-4067-4651
authors: Y
authors: Fogelman
authors: Epidemiology and Database Research, Maccabi Healthcare Services, Tel-Aviv, Israel.|Tel Aviv University, Tel Aviv, Israel.
authors: Inbal
authors: I
authors: Goldshtein
authors: The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.|Department of Endocrinology, Rambam Health Care Campus, Haifa, Israel.
authors: Elena
authors: E
authors: Segal
authors: Elisha Hospital, Haifa, Israel.
authors: Sofia
authors: S
authors: Ish-Shalom
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D058007:Physicians, Primary Care / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D013038:Specialization; D011795:Surveys and Questionnaires