title: A comparison of physical and behavioural characteristics between postmenopausal women with low bone mass on or off bone medication
Creators: name: Yong, Jedidah S
Publisher: name: Griffith University
Year: 2021
Subjects: subject: physical characteristics
subject: behavioural characteristics
subject: pharmacotherapy
subject: postmenopausal women
subject: bone health management

description: BACKGROUND: Identifying the relationships between physical and behavioural characteristics with the presence or absence of pharmacotherapy (on or off bone medication) for postmenopausal women with low bone mass could assist healthcare professionals to individualise bone health management plans and provide better patient-centred care. Linking patient characteristics with attitudes and motivations behind their decisions would be helpful for healthcare professionals in identifying what gaps in knowledge and types of therapy patients would most likely be open to initiating, adhering to and persisting. A cross-sectional study such as this has not previously been undertaken. METHODS: A convenience sample of 349 postmenopausal women with low bone mass were recruited from participants of the Medication and Exercise for Osteoporosis (MEDEX-OP) trial, women who were excluded from the MEDEX-OP trial and clients of The Bone Clinic in Brisbane, Australia. The baseline data from participants of the MEDEX-OP trial and the data from a routine assessment from clients of The Bone Clinic were obtained for analysis. A questionnaire requesting demographic information as well as attitudes toward medication and motivations to be on or off bone medication was emailed or sent via mail to women who had been excluded from the MEDEX-OP trial. Data was analysed via univariable and multivariable logistic regression to identify physical or behavioural characteristics related to being on or off bone medication. RESULTS: The majority of participants were aged in their early sixties, with 256 (73.4%) off bone medication and 93 (26.6%) currently taking antiresorptive bone medication. Age in years (OR 1.05, 95% CI 1.01-1.09), two or more fragility fractures (OR 5.08, 95% CI 2.60-9.94), previously took bone medication (OR 2.48, 95% CI 1.44-4.26), fracture risk calculated as a percentage using the Garvan Institute Fracture Risk Calculator (OR 1.03, 95% CI 1.01-1.06), back extensor strength measured in kilograms (OR 0.96, 95% CI 0.93-0.98), five times sit to stand measured in seconds (OR 1.16, 95% CI 1.04-1.30), and having a promedication attitude (OR 5.95, 95% CI 2.92-12.12) or ambivalent attitude toward medication in general (OR 1.51, 95% CI 0.73-3.09) were statistically significant variables that were found to be related to being on or off bone medication following the univariable logistic regression analyses. People with ambivalent attitudes were found to be just as likely as those with anti-medication attitudes to be on bone medication. At the adjusted multivariable level, having two or more fractures (OR 3.87, 95% CI 1.53-9.79), previous bone medication (OR 2.81, 95% CI 1.36-5.78), having poor back extension strength (OR 0.95, 95% CI 0.92-0.98), and having a pro-medication attitude (OR 6.41, 95% CI 2.73-15.07) were associated with being on bone medication. CONCLUSION: Fragility fracture history, previous use of bone medications, back extensor strength and attitudes toward medication in general were strongly related to being on or off bone medication among postmenopausal women with low bone mass. Healthcare professionals should consider these four characteristics when involving patients in the decision-making process of making a bone health management plan.