Hawarden, Ashley;
Bullock, Laurna;
García, Montserrat León;
Hartasanchez, Sandra A;
Maraboto, Andrea;
Jinks, Clare;
Kunneman, Marleen;
... Paskins, Zoe; + view all
(2025)
Getting to what matters for people with osteoporosis in clinical consultations with and without conversation aids: A videographic analysis.
Patient Education and Counseling
, 137
, Article 109171. 10.1016/j.pec.2025.109171.
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Abstract
Objective: To evaluate if, and how, clinicians elicit and address health and medicine beliefs in osteoporosis consultations, and to evaluate the impact of a conversation aid (CA) on clinician behaviour. // Methods: Secondary analysis of 107 video-recorded consultations from two trials evaluating CAs, using a bespoke coding tool to record the presence or absence of clinician shared decision-making (SDM) behaviours. In addition to descriptive statistics, Fisher’s exact test examined differences between consultations with and without CAs. // Results: Clinicians framed osteoporosis as a bone density (92 %) and/or fracture risk problem (78 % overall (96 % usual care vs 62 % aided, p < 0.001)). Biopsychosocial consequences of fractures were rarely mentioned. Clinicians asked questions to elicit beliefs in 58 % of consultations, most commonly general views on medications (47 % usual care vs 26 % aided, p = 0.03). Clinicians rarely asked about beliefs related to osteoporosis (n = 3), perceived need for (n = 1), concerns about (n = 5), or practical issues (n = 6) with medication. Clinicians used persuasion techniques more commonly in aided consultations (88 % vs 64 %, p = <0.001). Patient understanding was infrequently checked (12 %). // Conclusions: Clinicians miss opportunities to support patients to get the best from osteoporosis medications by tailoring communications to address necessity, beliefs, concerns and practicalities. // Practice implications: We need better methods for supporting clinicians in eliciting patient beliefs about osteoporosis and the medications recommended to treat it, including their need, safety, and practical issues.
| Type: | Article |
|---|---|
| Title: | Getting to what matters for people with osteoporosis in clinical consultations with and without conversation aids: A videographic analysis |
| Location: | Ireland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.pec.2025.109171 |
| Publisher version: | https://doi.org/10.1016/j.pec.2025.109171 |
| Language: | English |
| Additional information: | Copyright © 2025 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Osteoporosis, Shared Decision Making |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10208808 |
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