An Asian viewpoint on the use of vitamin D and calcium in osteoporosis treatment: Physician and patient attitudes and beliefs

<p>Abstract</p> <p>Background</p> <p>Osteoporosis treatment guidelines recommend calcium and vitamin D supplementation for both prevention as well as treatment, however, compliance with these guidelines is often unsatisfactory. This study investigated the opinion of Asian physicians and Asian patients regarding vitamin D and calcium and patients' use of both.</p> <p>Methods</p> <p>Physicians selected from Malaysia, Taiwan, Philippines, Korea and Singapore were asked to grade the significance of vitamin D and calcium in the treatment of osteoporosis and their patients' use of these supplements. In addition, physicians recruited seven eligible osteoporotic women to answer a questionnaire to determine their use of vitamin D and calcium, and their attitudes and beliefs regarding these supplements.</p> <p>Results</p> <p>In total, 237 physicians and 1463 osteoporosis patients completed the questionnaire. The results revealed that 22% of physicians in Malaysia, 12% in Taiwan, 72% in the Philippines, 50% in Korea and 24% in Singapore rated the importance of vitamin D supplementation as being extremely important. For calcium, 27% of physicians in Malaysia, 30% in Taiwan, 80% in the Philippines, 50% in Korea and 38% in Singapore rated the importance as being extremely important. Forty-three percent of patients in Malaysia, 38% in Taiwan, 73% in the Philippines, 35% in Korea and 39% in Singapore rated the importance of vitamin D as being extremely important. For calcium, 69% of patients in Malaysia, 58% in Taiwan, 90% in the Philippines, 70% in Korea and 55% in Singapore rated the importance as being extremely important. In addition, results of the patient questionnaire revealed that only a very small number regularly took both supplements. In addition, the results indicated that, with the exception of patients from the Philippines, the majority of patients had no or infrequent discussion with their physician about vitamin D and calcium.</p> <p>Conclusions</p> <p>There is generally suboptimal appreciation by both physicians and patients of the importance of vitamin D and calcium for maintenance of bone health as reflected in the low number of patients who reported regularly taking these supplements. Recognition of this problem should translate to appropriate action to improve education for both physicians and patients, with a goal to increase use of these supplements among Asian patients with osteoporosis.</p

Drugs and (Dis)order Key Informant Interviews in Kachin State Myanmar, 2019

Collection of 194 face-to-face semi-structured interviews with interviewees in Kachin State, northern Myanmar, carried out as part of the GCRF Drugs and (dis)order project. Interviews were carried out in the second year of the project to gather in-depth evidence on key research themes selected based on emerging findings from the 2018 interviews. Interviews focused on the themes (1) drugs and processes of political and economic change, (2) drugs and social change and the impact on families, and (3) responses to drugs and the impact of drug interventions.Drugs & (dis)order is a Global Challenges Research Fund (GCRF) project generating new evidence on how to transform illicit drug economies into peace economies in Afghanistan, Colombia and Myanmar. By 2030, more than 50% of the world’s poor will live in fragile and conflict-affected states. And many of today’s armed conflicts are fuelled by illicit drug economies in borderland regions. Trillions of dollars have been spent on the War on Drugs, but securitised approaches have failed. In fact, they often increase state fragility and adversely affect the health and livelihoods of communities and households. In light of these failures, there’s increasing recognition that drug policies need to be more pro-poor and aligned with the Sustainable Development Goals (SDGs). But the evidence base for this policy reform is patchy, politicised and contested. Drugs & (dis)order is helping to generate pro-poor policy solutions to transform illicit economies into peace economies. To do this we will: (1) Generate a robust evidence base on illicit drug economies and their effects on armed conflict, public health and livelihoods. (2) Identify new approaches and policy solutions to build more inclusive development and sustainable livelihoods in drugs affected contexts. (3) Build a global network of researchers and institutions in Afghanistan, Colombia, Myanmar and the UK to continue this work.</p

Drugs and (Dis)order Key Informant Interviews in Kachin State Myanmar, 2018

Collection of 261 face-to-face semi-structured interviews with interviewees in Kachin State, northern Myanmar, carried out as part of the GCRF Drugs and (dis)order project. Interviews were carried out in the first year of the project and explore narratives around illicit drugs across and within communities, and focus on the wider political and economic context of the area, issues around conflict and violence, and drug issues specifically. Evidence was generated on (1) how people interact with drugs and the drug economy, (2) the relationships between people, places and drugs, (3) organisations that shape people’s lives across Kachin State, including those that are related to drugs, (4) cultural engagement with drugs, and (5) economic dynamics of the Kachin borderland region and how they operate around drugs. The upland areas of Kachin are perfectly suited to the cultivation of opium poppy, which has provided livelihood security in impoverished rural areas but also became a financial pillar to sustain armed conflict. In recent decades, the relationship between drugs and conflict has become more complex. The issue has extended beyond opium cultivation to the manufacture and supply of other drugs, such as methamphetamines. Local communities are some of those must vulnerable to the harms related to changing patterns of drug use, including increasing levels of heroin-injecting and methamphetamine use.Drugs & (dis)order is a Global Challenges Research Fund (GCRF) project generating new evidence on how to transform illicit drug economies into peace economies in Afghanistan, Colombia and Myanmar. By 2030, more than 50% of the world’s poor will live in fragile and conflict-affected states. And many of today’s armed conflicts are fuelled by illicit drug economies in borderland regions. Trillions of dollars have been spent on the War on Drugs, but securitised approaches have failed. In fact, they often increase state fragility and adversely affect the health and livelihoods of communities and households. In light of these failures, there’s increasing recognition that drug policies need to be more pro-poor and aligned with the Sustainable Development Goals (SDGs). But the evidence base for this policy reform is patchy, politicised and contested. Drugs & (dis)order is helping to generate pro-poor policy solutions to transform illicit economies into peace economies. To do this we will: (1) Generate a robust evidence base on illicit drug economies and their effects on armed conflict, public health and livelihoods. (2) Identify new approaches and policy solutions to build more inclusive development and sustainable livelihoods in drugs affected contexts. (3) Build a global network of researchers and institutions in Afghanistan, Colombia, Myanmar and the UK to continue this work.</p

Drugs and (Dis)order Key Informant Interviews in Kachin State Myanmar, 2018

Collection of 261 face-to-face semi-structured interviews with interviewees in Kachin State, northern Myanmar, carried out as part of the GCRF Drugs and (dis)order project. Interviews were carried out in the first year of the project and explore narratives around illicit drugs across and within communities, and focus on the wider political and economic context of the area, issues around conflict and violence, and drug issues specifically. Evidence was generated on (1) how people interact with drugs and the drug economy, (2) the relationships between people, places and drugs, (3) organisations that shape people’s lives across Kachin State, including those that are related to drugs, (4) cultural engagement with drugs, and (5) economic dynamics of the Kachin borderland region and how they operate around drugs. The upland areas of Kachin are perfectly suited to the cultivation of opium poppy, which has provided livelihood security in impoverished rural areas but also became a financial pillar to sustain armed conflict. In recent decades, the relationship between drugs and conflict has become more complex. The issue has extended beyond opium cultivation to the manufacture and supply of other drugs, such as methamphetamines. Local communities are some of those must vulnerable to the harms related to changing patterns of drug use, including increasing levels of heroin-injecting and methamphetamine use.Drugs & (dis)order is a Global Challenges Research Fund (GCRF) project generating new evidence on how to transform illicit drug economies into peace economies in Afghanistan, Colombia and Myanmar. By 2030, more than 50% of the world’s poor will live in fragile and conflict-affected states. And many of today’s armed conflicts are fuelled by illicit drug economies in borderland regions. Trillions of dollars have been spent on the War on Drugs, but securitised approaches have failed. In fact, they often increase state fragility and adversely affect the health and livelihoods of communities and households. In light of these failures, there’s increasing recognition that drug policies need to be more pro-poor and aligned with the Sustainable Development Goals (SDGs). But the evidence base for this policy reform is patchy, politicised and contested. Drugs & (dis)order is helping to generate pro-poor policy solutions to transform illicit economies into peace economies. To do this we will: (1) Generate a robust evidence base on illicit drug economies and their effects on armed conflict, public health and livelihoods. (2) Identify new approaches and policy solutions to build more inclusive development and sustainable livelihoods in drugs affected contexts. (3) Build a global network of researchers and institutions in Afghanistan, Colombia, Myanmar and the UK to continue this work.</p

Drugs and (Dis)order Key Informant Interviews in Kachin State Myanmar, 2019

Collection of 194 face-to-face semi-structured interviews with interviewees in Kachin State, northern Myanmar, carried out as part of the GCRF Drugs and (dis)order project. Interviews were carried out in the second year of the project to gather in-depth evidence on key research themes selected based on emerging findings from the 2018 interviews. Interviews focused on the themes (1) drugs and processes of political and economic change, (2) drugs and social change and the impact on families, and (3) responses to drugs and the impact of drug interventions.Drugs & (dis)order is a Global Challenges Research Fund (GCRF) project generating new evidence on how to transform illicit drug economies into peace economies in Afghanistan, Colombia and Myanmar. By 2030, more than 50% of the world’s poor will live in fragile and conflict-affected states. And many of today’s armed conflicts are fuelled by illicit drug economies in borderland regions. Trillions of dollars have been spent on the War on Drugs, but securitised approaches have failed. In fact, they often increase state fragility and adversely affect the health and livelihoods of communities and households. In light of these failures, there’s increasing recognition that drug policies need to be more pro-poor and aligned with the Sustainable Development Goals (SDGs). But the evidence base for this policy reform is patchy, politicised and contested. Drugs & (dis)order is helping to generate pro-poor policy solutions to transform illicit economies into peace economies. To do this we will: (1) Generate a robust evidence base on illicit drug economies and their effects on armed conflict, public health and livelihoods. (2) Identify new approaches and policy solutions to build more inclusive development and sustainable livelihoods in drugs affected contexts. (3) Build a global network of researchers and institutions in Afghanistan, Colombia, Myanmar and the UK to continue this work.</p