Perceptions and attitudes of patients towards medication-related osteonecrosis of the jaw (MRONJ): A qualitative study in England

TY - JOUR

T1 - Perceptions and attitudes of patients towards medication-related osteonecrosis of the jaw (MRONJ)

T2 - A qualitative study in England

AU - Sturrock, Andrew

AU - Preshaw, Philip M.

AU - Hayes, Catherine

AU - Wilkes, Scott

N1 - Funding Information: Funding This work was supported by the 2016 Pharmacy Research UK and the United Kingdom Clinical Pharmacy Association Research Award. Publisher Copyright: © 2019 Author(s).

PY - 2019/3/3

Y1 - 2019/3/3

N2 - Objective To explore the impact of medication-related osteonecrosis of the jaw (MRONJ) on quality of life and to explore the attitudes and perceptions of patients towards the multidisciplinary approach to the prevention of the condition. Design Interpretivist methodology using qualitative semistructured interviews. Setting Primary care general medical practices and secondary care dental services in England. Participants 23 patients; 6 with MRONJ, 13 prescribed bisphosphonates, 4 with osteoporosis not currently prescribed any medication. Results Patients felt that MRONJ had a significant negative impact on their quality of life and had poor knowledge of the preventive strategies recommended in the literature. Patients demonstrated positive attitudes towards a multidisciplinary approach to care; however, they perceived prescribers as having the key role in articulating risk. Four salient and inter-related themes emerged from the interviews: (1) perception of knowledge, indicating limited awareness of the condition, risk factors and preventive strategies; (2) quality of life, indicating the lived experiences of patients and the physical, psychological and social impacts of MRONJ; (3) interprofessional management, indicating a perceived organisational hierarchy, professional roles and responsibilities, prioritising aspects of care, articulation of risk and communication and (4) wider context, indicating demands on National Health Service resources and barriers to dental care. Conclusions MRONJ has a significant detrimental impact on quality of life, yet appropriate preventative education is not apparent. Effective interprofessional patient education and prevention to mitigate against the risk of developing MRONJ is required.

AB - Objective To explore the impact of medication-related osteonecrosis of the jaw (MRONJ) on quality of life and to explore the attitudes and perceptions of patients towards the multidisciplinary approach to the prevention of the condition. Design Interpretivist methodology using qualitative semistructured interviews. Setting Primary care general medical practices and secondary care dental services in England. Participants 23 patients; 6 with MRONJ, 13 prescribed bisphosphonates, 4 with osteoporosis not currently prescribed any medication. Results Patients felt that MRONJ had a significant negative impact on their quality of life and had poor knowledge of the preventive strategies recommended in the literature. Patients demonstrated positive attitudes towards a multidisciplinary approach to care; however, they perceived prescribers as having the key role in articulating risk. Four salient and inter-related themes emerged from the interviews: (1) perception of knowledge, indicating limited awareness of the condition, risk factors and preventive strategies; (2) quality of life, indicating the lived experiences of patients and the physical, psychological and social impacts of MRONJ; (3) interprofessional management, indicating a perceived organisational hierarchy, professional roles and responsibilities, prioritising aspects of care, articulation of risk and communication and (4) wider context, indicating demands on National Health Service resources and barriers to dental care. Conclusions MRONJ has a significant detrimental impact on quality of life, yet appropriate preventative education is not apparent. Effective interprofessional patient education and prevention to mitigate against the risk of developing MRONJ is required.

KW - medication-related osteonecrosis of the jaw (MRONJ)

KW - Patient perception

UR - https://www.scopus.com/pages/publications/85062383953

U2 - 10.1136/bmjopen-2018-024376

DO - 10.1136/bmjopen-2018-024376

M3 - Article

C2 - 30833319

AN - SCOPUS:85062383953

SN - 2044-6055

VL - 9

JO - BMJ Open

JF - BMJ Open

IS - 3

M1 - e024376

ER -