Awareness among patient at risk of developing Medication Related Osteonecrosis of the Jaw (MRONJ) - A primary prevention strategy

Saudi Pharm J. 2020 Jun;28(6):771-778. doi: 10.1016/j.jsps.2020.05.004. Epub 2020 May 15.

Abstract

The quality of life, in itself, in cancer patients or in osteoporotic individuals, without even considering the side effects of the medication in the first place, has a considerable negative impact on the clinical outcome. The Medication Related Osteonecrosis of the Jaw (MRONJ), in the maxillofacial region, although rare, needs to be addressed with the prime importance. One of the key components of any given preventive treatment strategy is to, create awareness about the medication related unwanted effects, among health care professionals and patients.

Objective: This study is aimed to explore and assess the awareness level among dental patients about MRONJ, the risk factors, and the high-risk category (who are prone to develop MRONJ).

Material and methods: This is a prospective interviewer administered research electronic data capture (REDCap) survey. The sample included 68 patients, who are currently taking or will be taking Bisphosphonate (BP), and/or Denosumab, and anti-Angiogenic agent. Data have been analyzed using IBM SPSS software.

Results: Sixty-eight patients (18 males and 50 females), participated in this study. Only 23 subjects (33.82%) were aware about the MRONJ. Females were more aware about the complications than males. The awareness among the subjects with education at college level appears to be higher than the subjects having education less than high school level. Even though, a dental check- up, is mandatory, prior to starting these medications, to see if any dental treatment is required, only slightly more than half of the patients (54.72%) had a dental checkup.

Conclusion: This is a novel study in the Middle- East, used to assess awareness about the MRONJ including three type of related medications. Low awareness of MRONJ is alarming. The results of the study will help to initiate the process of providing the education materials, about the side effects and importance of oral hygiene maintenance, giving priority to improve the quality of life in such patients. Awareness of patients regarding the complications must be an important part of health care practice guidelines.

Keywords: AAOMS, American Academy of Oral Medicine; Antiangiogenics; Awareness; BP, Bisphosphonate; Bisphosphonate; Denosumab; Dental; IV, Intravenous; MRONJ, Medication Related Osteonecrosis of Jaw; Medication Related Osteonecrosis of the Jaw (MRONJ); ONJ, Osteonecrosis of Jaw; PI, Principal investigator; REDcap, Research Electronic data capture; mTOR inhibitor, mammalian target of Rapamycin.