Oliver, D.G.; Trewby, P.N.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA70
Academic Journal
Background: The British Society of Gastroenterology guidelines for osteoporosis in inflammatory bowel disease imply the screening of a large proportion of inflammatory bowel disease patients and treatment with antiresorptive medication if necessary. Despite this, only a small percentage of patients will benefit from fracture prevention as a direct result of taking this medication. Aims: To explore inflammatory bowel disease patients' attitudes towards taking medication for osteoporosis in the light of present best evidence for fracture reduction with such medication. Methods: Questionnaires were sent to all patients on an inflammatory bowel disease database at a district general hospital in North East England. The main outcome measure was the lower limit of absolute risk reduction of fracture below which subjects were not prepared to take a hypothetical osteoporosis drug for three years. All responders were followed up with a telephone interview. Results: 121 (45%) patients responded. The median value for the lower limit of absolute risk reduction of fracture acceptable to the study population was 50%. There was no significant correlation between the value expressed by the patient and their age, number of previous fractures or current or previous steroid use. Patients who had suffered a fracture within the previous two years showed a significantly lower threshold to taking osteoporosis medication than those with no previous fracture. Patients exhibited wide variations in their attitudes towards taking the preventive treatment with 20% being concerned about possible side effects. 85% wished to have a discussion about the expected benefits of any new preventive drug prior to starting treatment. Conclusions: Inflammatory bowel disease patients may not be prepared to take osteoporosis medication if they were aware of its true likelihood of benefit. Gastroenterologists should consider their patients' attitudes as well as the medical criteria before deciding to treat...


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