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Propensity of gynaecologists towards osteoporosis management and treatment
Serge Rozenberg1, Daniel Murillo, Rudy Gevers
1Department of Obstetrics and Gynaecology CHU Saint-Pierre, Université Libre de Buxelles, 322 rue Haute, 1000 Brussels, Belgium. serge.rozenberg@skynet.be
Background:
Regulation authorities have recently advised against the use of hormone replacement therapy (HRT) as a first choice treatment for postmenopausal osteoporosis, modifying the past consensus.
Aim:
Analyse the sensibility to and prescription attitude for osteoporosis.
Setting:
Survey.
Population:
Belgian gynaecologists.
Methods:
Case construction: two cases to assess whether gynaecologists are prone to detect osteoporosis, and six others to evaluate their prescription attitude for osteoporosis.
Results:
About 80% of the physicians would prescribe a bone mineral density measurement (BMD) to a 66-year-old, non HRT user. About 60% prescribed calcium and Vitamin D when the BMD was normal, 90% would prescribe it when the BMD showed osteopenia or osteoporosis (p < 0.001). Few prescribed HRT (< 25%). Few advised SERMS for normal BMD, 19%-47% prescribed it in osteopenia or osteoporosis (p < 0.001). Few considered a biphosphonate in normal BMD, or osteopenia in the absence of risk factors, 25% considered it in osteopenia in the presence of risk factors, and 80% in osteoporosis (p < 0.001).
Conclusion:
Most gynaecologists are aware of the osteoporosis problem. They often screen non HRT users and in the event of osteoporosis, they initiate a specific treatment, not HRT, but generally a combination of calcium, Vitamin D and biphosphonates.
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