Non-pharmacological management of osteoporotic vertebral fractures: health-care professional perspectives and experiences

Abstract

Purpose

To understand experiences and perceptions on non-pharmacological treatment of vertebral fractures and virtual-care from the perspective of care professionals’ (HCPs)

Design and setting

We conducted semi-structured interviews with 13 HCPs within Canada (7 F, 6 M, aged 46 ± 12 years) and performed a thematic and content analysis from a post-positivism perspective.

Results

Two themes were identified: acuity matters when selecting appropriate interventions; and roadblocks to receiving non-pharmacological interventions. We found that treatment options were dependent on the acuity/stability of fracture and were individualized accordingly. Pain medication was perceived as important, but non-pharmacological strategies were also considered helpful in supporting recovery. Participants discussed barriers related to the timely identification of fracture, referral to physiotherapy, and lack of knowledge among HCPs on how to manage osteoporosis and vertebral fractures. HCPs reported positive use of virtual-care, but had concerns related to patient access, cost, and comprehensive assessments.

Conclusion

HCPs used and perceived non-pharmacological interventions as helpful and selected specific treatments based on the recency of fracture and patient symptoms. HCPs’ also believed that virtual-care that included an educational component, an assessment by a physiotherapist, and an exercise group was a feasible alternative, but concerns exist and may require further evaluation.

IMPLICATIONS FOR REHABILITATION

• Non-pharmacological strategies in combination with pain medication may be a more effective strategy to support recovery than pain medication alone but should be informed by fracture acuity and patient symptoms.

• To improve access to physiotherapy and other non-pharmacological treatment options during the acute or chronic management of vertebral fractures, it may be worthwhile to explore the effectiveness and feasibility of virtual-care.

Keywords:

• Osteoporosis
• rehabilitation
• healthcare
• vertebral fractures
• lived experience
• experiences
• physiotherapy
• qualitative

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The authors acknowledge the support of the Natural Sciences and Engineering Research Council of Canada (NSERC), CREATE 509950–2018 Training in Global Biomedical Technology Research and Innovation. JC Gibbs is the recipient of a Fonds de recherche du Québec–Santé (FRQS) Research Scholar Award.