Osteoporosis beliefs and antiresorptive medication use

Objective: Although a number of prescription medications are effective for the prevention and treatment of osteoporosis, little is known about the role of beliefs and attitudes in women decisions to use these drugs. The objectives of this study were (1) to assess the role of beliefs and attitudes regarding osteoporosis and prescription antiresorptive drugs in the decision to use newer antiresorptive medicines (such as bis-phosphonates, selective estrogen receptor modulators, and calcitonin nasal) and (2) to assess the role of these same beliefs and attitudes in the decision to use hormone therapy. Design: Data were collected using a cross-sectional survey mailed to 1700 community dwelling women age 45 and older residing in Minnesota. Respondents completed measures of health belief model constructs, medication profiles and demographics. Data were analyzed using multivariate logistic regression models. Results: A total of 983 usable survey forms were returned, yielding an adjusted response rate of 60.7%. More than one quarter of respondents reported using a prescription antiresorptive agent, with 90 (9.2%) currently taking a newer antiresorptive agent and 163 (16.6%) using hormone therapy. Several health belief model components were predictive of newer antiresorptive medicine use, including higher perceptions of susceptibility to osteoporosis (OR 1.34, 95% CI 1.20-1.49), perceptions of strong benefits of antiresorptive medicines (OR 1.34, 95% CI 1.10-1.63), and perceptions of few barriers to the use of antiresorptive medicines (OR 0.51, 95% CI 0.38-0.67). Several cues to action also were predictive of newer antiresorptive medicine use. Use of hormone therapy was associated with a single cue to action (being tested for osteoporosis (OR 1.74, 95% CI 1.14-2.66) and the perception of few barriers to the use of prescription antiresorptives (OR 0.65, 95% CI 0.55-0.77). Conclusion: Several health belief model constructs were associated with the decision to use newer antiresorptive drugs relative to no prescription therapy. However, few model components as operationalized in this study were predictive of the use of hormone therapy. Although the health belief model appears to provide a plausible model of the decision to undertake newer antiresorptive drug therapy, it explains little about women use of hormone therapy.