Summary

We surveyed primary care physicians in Malaysia for their knowledge, attitude and practice in screening and managing osteoporosis. We found a low level of screening and active management of osteoporosis in the primary care setting despite positive attitudes towards them. We advocate for the active management of osteoporosis at the primary care level.

Introduction

Prevention of osteoporotic fracture is important in primary healthcare for healthy ageing. Little is known about the knowledge, attitude, practice and barriers in the screening and managing osteoporosis among primary care doctors.

Methods

A cross-sectional study, using an online pre-tested questionnaire after face and content validation, was conducted for primary care doctors from 1 June to 30 July 2021 across Malaysia. Pearson’s chi-square test and logistic regression were employed.

Results

A total of 350 primary care doctors in Malaysia, consisting of 113 (32.3%) family medicine specialists (FMS) and 237 (67.7%) medical officers, participated in this study. The mean ± SD score of osteoporosis knowledge was 50.46 ± 15.09 with minimum and maximum values of 0 and 83.64%, respectively. One hundred and ten (31.4%) respondents achieved a satisfactory overall knowledge score of ≥ 60%, 156 (44.6%) were confident in advising patients for initiation of anti-osteoporotic medication, and 243 (69.4%) perceived that bisphosphonate should be made available in health clinics. Only 97 (27.7%) practised osteoporosis screening. Inaccessibility of bone mineral densitometry (BMD) (90.6%), inadequate knowledge (87.7%) and inaccessibility of pharmacotherapy (87.1%) are perceived modifiable barriers to osteoporosis screening and management. Factors associated with a satisfactory knowledge of osteoporosis are designation as a family medicine specialist (AOR 3.034, p = 0.002), attendance at an osteoporosis management update course (AOR 2.095, p = 0.034) and the practice of osteoporosis screening for the elderly (AOR 2.767, p = 0.001).

Conclusion

Given the insufficient knowledge and low level of osteoporosis screening, there is a need for a national structured health programme to address the knowledge gap, increase screening practices and enhance accessibility to BMD and anti-osteoporosis medication in primary care.

中文翻译：

---

骨质疏松症的筛查和管理：马来西亚初级保健医生的知识、态度和实践调查

概括

我们调查了马来西亚的初级保健医生在筛查和管理骨质疏松症方面的知识、态度和实践。我们发现初级保健机构对骨质疏松症的筛查和积极管理水平较低，尽管对他们持积极态度。我们提倡在初级保健层面积极管理骨质疏松症。

介绍

预防骨质疏松性骨折对于健康老龄化的初级保健非常重要。初级保健医生在筛查和管理骨质疏松症方面的知识、态度、实践和障碍知之甚少。

方法

2021 年 6 月 1 日至 7 月 30 日，在马来西亚各地的初级保健医生中，使用经过面部和内容验证后的在线预测试问卷进行了一项横断面研究。采用 Pearson 的卡方检验和逻辑回归。

结果

马来西亚共有 350 名初级保健医生参与了这项研究，其中包括 113 名 (32.3%) 家庭医学专家 (FMS) 和 237 名 (67.7%) 医务人员。骨质疏松知识的平均 ± SD 得分为 50.46 ± 15.09，最小值和最大值分别为 0 和 83.64%。一百一十名 (31.4%) 受访者的总体知识得分≥ 60%，156 名 (44.6%) 有信心建议患者开始使用抗骨质疏松药物，243 名 (69.4%) 认为应该使用双膦酸盐可在健康诊所获得。只有 97 人 (27.7%) 进行了骨质疏松症筛查。无法获得骨矿物质密度测定 (BMD) (90.6%)、知识不足 (87.7%) 和无法获得药物治疗 (87.1%) 是骨质疏松症筛查和管理的可改变障碍。p  = 0.002），参加骨质疏松症管理更新课程（AOR 2.095，p  = 0.034）和老年人骨质疏松症筛查实践（AOR 2.767，p  = 0.001）。

结论

鉴于骨质疏松症筛查知识不足和水平低下，需要一个国家结构化健康计划来解决知识差距，增加筛查实践并提高初级保健中 BMD 和抗骨质疏松症药物的可及性。