Knowledge level of physicians prescribing bisphosphonates: prevention
and treatment of bisphosphonate-related osteonecrosis of the jaw
Abstract
Rationale, aims and objectives: Bisphosphonate-related osteonecrosis of
the jaw (BRONJ) is an important uncommon complication. Due to its
complexity, its prevention requires a multidisciplinary approach,
involving physicians and dental clinicians. This study aimed to assess
the knowledge level of physicians prescribing bisphosphonates in Tehran
about dental considerations in such patients and prevention and
treatment of BRONJ in 2019. Methods: This descriptive, cross-sectional
study evaluated 100 physicians (rheumatologists, endocrinologists,
oncologists, and orthopedists) practicing in Tehran. A questionnaire
comprising of a demographic section, and knowledge questions regarding
dental considerations in patients taking bisphosphonates was
administered among the physicians. The frequency of qualitative
variables such as gender, type of specialty, and physicians’ responses
to each question was calculated, and the knowledge scores were analyzed
separately based on the type of specialty of physicians using one-way
ANOVA followed by the Tukey’s test for pairwise comparisons. The effect
of different variables on knowledge score was analyzed by simple
regression. Results: The mean knowledge score of physicians was
5.19±1.78 (range 2-8). The mean knowledge score of oncologists was
significantly higher than that of endocrinologists (5.88 versus 4.52,
P=0.03). No other significant differences were noted. Work experience
(P=0.04), age (P=0.02), orthopedics specialty (P=0.05) and oncology
specialty (P=0.006) had significant effects on the knowledge score. Type
of practice (P=0.75), gender (P=0.32), and rheumatology specialty
(P=0.07) had no significant effect on the knowledge score. Conclusion:
Considering acquiring about 50% of the total score, physicians seem to
have limited knowledge about dental considerations in patients taking
bisphosphonates. Attempts must be made to enhance their knowledge by the
continuing education programs or revising the curricula.