Postmenopausal osteoporosis: general practitioners' application of the risk factors in the AFSSAPS guidelines. Survey of 2658 general practitioners

摘要

OBJECTIVES: Although AFSSAPS has set forth the recommended treatment strategies for postmenopausal osteoporosis, little is known about how this disorder is managed in general practice. The objective of the APOTEOS Observatory was to describe the profiles of patients with postmenopausal osteoporosis and to identify the factors influencing its treatment. METHODS: This national descriptive, cross-sectional, epidemiologic study included patients seen for postmenopausal osteoporosis by a representative sample of 2658 general practitioners, who were to prospectively include four patients with osteoporosis selected during a standard follow-up visit. To identify the factors influencing the treatment strategy, patients were classified into three groups: those with no specific osteoporosis treatment envisioned (group A), those for whom specific osteoporosis treatment was envisioned, without any additional treatment (group B), and patients who would receive specific osteoporosis treatment combined with vitamin and calcium supplements or other dietary measures (group C). RESULTS: The groups did not differ in the proportion of women with a BMI <19 kg/m(2). The prevalence of a personal or family (1st-degree relative) fracture history and of early menopause did differ according to treatment strategy, as did the percentage of women with back pain and the amplitude of their height loss. Bone density testing was performed for 74% of the patients, and its results also differed significantly according to treatment strategy. CONCLUSION: The prevalence of the standard risk factors for osteoporosis and of clinical symptoms of vertebral fractures, as well as the bone density testing results, differed significantly according to the treatment strategy planned by the general practitioners. These physicians had considered and complied with the AFSSAPS guidelines, and they took these risk factors into account in deciding on treatment.