Copyright
©The Author(s) 2017.
World J Rheumatol. Mar 12, 2017; 7(1): 1-7
Published online Mar 12, 2017. doi: 10.5499/wjr.v7.i1.1
Published online Mar 12, 2017. doi: 10.5499/wjr.v7.i1.1
Table 1 Bisphosphonates-reported side effects, characteristics, and rating
Side effects | BPs incriminated | Causality link | Rating of correct answers | Rating of false answers |
Upper GI intolerance | Oral amino-BPs | Established | 2 | 0 |
Acute phase reaction | IV amino-BPs | Established | 2 | 0 |
Hypocalcaemia | IV > oral BPs | Established | 2 | 0 |
Renal toxicity | Zoledronate and pamidronate | Established | 2 | 0 |
Severe musculoskeletal pain | Oral BPs | Probable | 1 | 0 |
Ocular inflammation | All BPs | Probable | 1 | 0 |
Atypical femoral fractures | BPs treatment for osteoporosis | Probable | 1 | 0 |
Osteonecrosis of the jaw | IV BPs treatment in oncology | Probable | 1 | 0 |
Atrial fibrillation | --- | Unproven | 1 | -1 |
Esophageal cancer | --- | Unproven | 1 | -1 |
Hepatotoxicity | --- | Unproven | 1 | -1 |
Table 2 Our 157 physicians’ knowledge, fear and experience regarding bisphosphonates-reported side effects
Side effects | Reported by physicians n (%) | Feared by physicians n (%) | Encountered by physicians n (%) |
Acute phase reaction | 86 (54.8) | 12 (7.6) | 42 (26.8) |
Atrial fibrillation | 21 (13.4) | 12 (7.6) | 0 (0.0) |
Atypical femoral fractures | 67 (42.7) | 48 (30.6) | 13 (8.3) |
Esophageal cancer | 18 (11.5) | 11 (7.0) | 0 (0.0) |
Hepatotoxicity | 39 (24.8) | 18 (11.5) | 2 (1.3) |
Hypocalcaemia | 72 (45.9) | 33 (21.0) | 27 (17.2) |
Ocular inflammation | 12 (7.6) | 3 (1.9) | 2 (1.3) |
Osteonecrosis of the jaw | 118 (75.2) | 93 (59.2) | 38 (24.2) |
Renal toxicity | 84 (53.5) | 67 (42.7) | 33 (21.0) |
Severe musculoskeletal pain | 59 (37.6) | 10 (6.4) | 24 (15.3) |
Upper GI intolerance | 122 (77.7) | 45 (28.7) | 70 (44.6) |
No side effect | 2 (1.3) | 7 (4.5) | 32 (20.4) |
Table 3 Univariate analyses of factors associated with the level of knowledge
Independent variables | Knowledge score (mean ± SD) | n | P-value |
Professional position | 0.232 | ||
Professor | 8.82 ± 2.83 | 17 | |
Attending physician | 8.65 ± 2.57 | 54 | |
Fellowship resident | 7.93 ± 2.90 | 86 | |
Department affiliation | < 0.0001a | ||
Medical | 8.92 ± 2.55 | 114 | |
Surgical | 6.56 ± 2.69 | 43 | |
Department affiliation | < 0.0001a | ||
Rheumatology | 10.62 ± 2.83 | 8 | |
Oncology | 10.10 ± 1.77 | 20 | |
Nephrology | 9.70 ± 2.63 | 10 | |
Endocrinology | 9.45 ± 2.51 | 11 | |
Internal medicine | 8.21 ± 2.48 | 29 | |
Family medicine | 8.08 ± 2.52 | 36 | |
Orthopedics | 7.38 ± 3.09 | 21 | |
Gynecology | 5.77 ± 2.02 | 22 | |
Age | 0.213 | ||
< 30 yr | 7.91 ± 2.87 | 80 | |
30-50 yr | 8.53 ± 2.77 | 55 | |
> 50 yr | 8.95 ± 2.46 | 22 | |
Gender | 0.016a | ||
Male | 7.84 ± 2.63 | 95 | |
Female | 8.94 ± 2.91 | 62 | |
No. of patients attended per day | 0.874 | ||
< 10 patients | 8.29 ± 2.84 | 52 | |
10-20 patients | 8.32 ± 2.89 | 65 | |
> 20 patients | 8.03 ± 2.42 | 34 | |
No. of medical sales representatives received per week | 0.149 | ||
0 | 7.55 ± 2.60 | 20 | |
< 10 | 7.98 ± 2.76 | 86 | |
10-20 | 8.91 ± 2.62 | 34 | |
> 20 | 9.07 ± 2.99 | 14 | |
Time consumed for patients care | 0.906 | ||
< 25% | 8.25 ± 2.06 | 4 | |
25%-50% | 8.00 ± 2.77 | 37 | |
51%-75% | 8.43 ± 2.88 | 68 | |
> 75% | 8.25 ± 2.75 | 44 | |
Time consumed for academic work | 0.171 | ||
< 25% | 8.23 ± 2.78 | 57 | |
25%-50% | 8.42 ± 2.80 | 76 | |
51%-75% | 7.25 ± 2.54 | 16 | |
> 75% | 10.50 ± 1.91 | 4 | |
BP prescription | 0.001a | ||
Yes | 8.78 ± 2.69 | 108 | |
No | 7.16 ± 2.70 | 49 | |
No. of BP prescriptions delivered per month | 0.006a | ||
≤ 5 prescriptions | 8.27 ± 2.64 | 73 | |
6-10 prescriptions | 9.70 ± 2.46 | 27 | |
> 10 prescriptions | 10.86 ± 2.48 | 7 | |
Most frequent form of BP prescribed | 0.033a | ||
Oral form | 8.48 ± 2.73 | 87 | |
Intravenous form | 9.90 ± 2.22 | 20 | |
No. of patients on BP attended per month | < 0.0001a | ||
0 patient | 6.64 ± 2.06 | 11 | |
1-5 patients | 7.85 ± 2.52 | 81 | |
6-10 patients | 8.26 ± 2.81 | 34 | |
> 10 patients | 9.97 ± 2.99 | 31 |
Table 4 Multiple regression analysis of factors associated with the level of knowledge
Unstandardized coefficients | Standardized coefficients | Student | P-value | Partial correlations | ||
β | Standard error | β | ||||
Department affiliation | 1.253 | 0.610 | 0.201 | 2.054 | 0.043a | 0.204 |
Gender | 1.103 | 0.539 | 0.194 | 2.045 | 0.044a | 0.203 |
No. of medical sales representatives received per week | 0.167 | 0.330 | 0.048 | 0.506 | 0.614 | 0.051 |
Time consumed for academic work | 0.144 | 0.331 | 0.038 | 0.434 | 0.665 | 0.044 |
BP prescription | -1.455 | 0.566 | -0.242 | -2.569 | 0.012a | -0.252 |
No. of BP prescriptions delivered per month | 1.106 | 0.431 | 0.241 | 2.567 | 0.012a | 0.252 |
Most frequent form of BP prescribed | 0.870 | 0.671 | 0.122 | 1.296 | 0.198 | 0.130 |
- Citation: El Osta L, El Osta N, Tannous R, Aoun A, Ghosn M, El Osta H. Physicians’ knowledge and attitude regarding bisphosphonates-related adverse events: An observational study. World J Rheumatol 2017; 7(1): 1-7
- URL: https://www.wjgnet.com/2220-3214/full/v7/i1/1.htm
- DOI: https://dx.doi.org/10.5499/wjr.v7.i1.1