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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Christine G. Unson, PhD, Claude Pepper Older Americans Independent Center, Center on Aging, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT 06030-6147, Eduardo Siccion, Department of Medicine, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT CT06030=6147, (860) 679=2239, Delapaz@nso1.uchc.edu, Sonia Gaztambide, Braceland Center for Mental Health and Aging, 200 Retreat Avenue, Hartford, CT 06106, and Jose Gaztambide, Department of Communication Science, University of Connecticut, Bolton Road, Storrs, CT 06269.
AIM: The medication preferences of elderly women in selecting treatment for osteoporosis were explored. METHODS: Five focus groups comprised of 29 older black, 10 Hispanic, and 11 white women not on treatment for osteoporosis were conducted (mean age 73). Participants were recruited from senior centers and senior housing. Intention to use calcium, estrogen replacement, bisphosphonates, and raloxifene was discussed after risks (e.g., side-effects, financial costs, cancer and blood clots risks) and benefits (e.g., reduction in hip fracture and cardiovascular risks) of each treatment were presented. RESULTS: Some participants with fall history preferred no treatment because they did not feel susceptible to fractures. Those who felt susceptible and were distrustful of medications opted for lifestyle changes that prevent falls. Calcium was selected due to lower costs and side effects despite higher fracture risks. Estrogen was rejected because of risk of cancer and clotting despite benefits (cardiovascular risk reduction, memory improvement). Raloxifene was rejected because of clotting risks and costs. Bisphosphonates was favored because of higher fracture risk reduction and convenience of weekly dosing but was rejected by women without prescription coverage. CONCLUSIONS and RECOMMENDATIONS: Perceived lack of susceptibility to hip fractures and negative attitudes towards medication hindered their decision to adopt a treatment. Low cost, few side effects, convenient dosing and prescription coverage were given more consideration in treatment selection than high fracture risk reduction. To enhance patient adherence, physicians’ prescribing practices should incorporate disclosure of benefits and costs of treatment options and encourage patient participation in selecting treatment.
Learning Objectives:
Keywords: Adherence, Decision-Making
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.