{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:39:10Z","timestamp":1787017150052,"version":"build-2736575974"},"reference-count":27,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/501100002121","name":"Pharmacy Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002121","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,1,8]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the impact of medication-related osteonecrosis of the jaw (MRONJ) on quality of life and to explore the attitudes and perceptions of patients towards the multidisciplinary approach to the prevention of the condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Interpretivist methodology using qualitative semistructured interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary care general medical practices and secondary care dental services in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>23 patients; 6 with MRONJ, 13 prescribed bisphosphonates, 4 with osteoporosis not currently prescribed any medication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients felt that MRONJ had a significant negative impact on their quality of life and had poor knowledge of the preventive strategies recommended in the literature. Patients demonstrated positive attitudes towards a multidisciplinary approach to care; however, they perceived prescribers as having the key role in articulating risk. Four salient and inter-related themes emerged from the interviews: (1) perception of knowledge, indicating limited awareness of the condition, risk factors and preventive strategies; (2) quality of life, indicating the lived experiences of patients and the physical, psychological and social impacts of MRONJ; (3) interprofessional management, indicating a perceived organisational hierarchy, professional roles and responsibilities, prioritising aspects of care, articulation of risk and communication and (4) wider context, indicating demands on National Health Service resources and barriers to dental care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MRONJ has a significant detrimental impact on quality of life, yet appropriate preventative education is not apparent. Effective interprofessional patient education and prevention to mitigate against the risk of developing MRONJ is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-024376","type":"journal-article","created":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T04:35:35Z","timestamp":1551674135000},"page":"e024376","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Perceptions and attitudes of patients towards medication-related osteonecrosis of the jaw (MRONJ): a qualitative study in England"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3316-1412","authenticated-orcid":false,"given":"Andrew","family":"Sturrock","sequence":"first","affiliation":[{"name":"School of Pharmacy and Pharmaceutical Sciences, University of Sunderland, Sunderland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7153-4865","authenticated-orcid":false,"given":"Philip M","family":"Preshaw","sequence":"additional","affiliation":[{"name":"National University Centre for Oral Health, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Hayes","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Wilkes","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Sunderland, Sunderland, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,3]]},"reference":[{"key":"2025121400474657000_9.3.e024376.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2014.04.031"},{"key":"2025121400474657000_9.3.e024376.2","unstructured":"Medicines Healthcare Regulatory Agency. Drug Safety Update: Bisphosphonates: osteonecrosis of the jaw. 2009 https:\/\/www.gov.uk\/drug-safety-update\/bisphosphonates-osteonecrosis-of-the-jaw (Accessed 2 Apr 2018)."},{"key":"2025121400474657000_9.3.e024376.3","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.1016\/j.oooo.2012.03.032","article-title":"Composition of the blood supply in the sublingual and submandibular spaces and its relationship to the lateral lingual foramen of the mandible","volume":"117","author":"Nakajima","year":"2014","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"2025121400474657000_9.3.e024376.4","doi-asserted-by":"crossref","first-page":"149","DOI":"10.5603\/FM.a2015.0095","article-title":"Cone beam computed tomography investigation of the antral artery anastomosis in a population of Central Italy","volume":"75","author":"Bernardi","year":"2016","journal-title":"Folia Morphol"},{"key":"2025121400474657000_9.3.e024376.5","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1007\/s00276-017-1888-x","article-title":"Frequency and anatomical features of the mandibular lingual foramina: systematic review and meta-analysis","volume":"39","author":"Bernardi","year":"2017","journal-title":"Surg Radiol Anat"},{"key":"2025121400474657000_9.3.e024376.6","unstructured":"Gray H . Gray\u2019s anatomy: the anatomical basis of medicine and surgery. 39th edn. London: Churchill Livingston Elsevier, 2004."},{"key":"2025121400474657000_9.3.e024376.7","unstructured":"Scottish Dental Clinical Effectiveness Programme. Oral Health management of patients at risk of medication-related osteonecrosis of the jaw. Dental clinical guidance. Scottish Dental Clinical Effectiveness Programme: Dundee, 2017."},{"key":"2025121400474657000_9.3.e024376.8","doi-asserted-by":"crossref","unstructured":"Bernardi S , Di Girolamo M , Necozione S , et al . Antiresorptive drug-related osteonecrosis of the jaws\u00a0literature review and 5 years of experience Musculoskelet Surg. 2018 https:\/\/doi.org\/","DOI":"10.1007\/s12306-018-0548-6"},{"key":"2025121400474657000_9.3.e024376.9","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.2405"},{"key":"2025121400474657000_9.3.e024376.10","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdn554"},{"key":"2025121400474657000_9.3.e024376.11","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr039"},{"key":"2025121400474657000_9.3.e024376.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03713.x"},{"key":"2025121400474657000_9.3.e024376.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2010.05.007"},{"key":"2025121400474657000_9.3.e024376.14","unstructured":"European Medicines Agency. CHMP Assessment report on bisphosphonates and osteonecrosis of the jaw, london: european medicines agency]. 2009. http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Report\/2010\/01\/WC500051428.pdf (Accessed 2 Apr 18)."},{"key":"2025121400474657000_9.3.e024376.15","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1111\/j.1601-5037.2008.00331.x","article-title":"Bisphosphonate-related jaw necrosis: a team approach management and prevention","volume":"7","author":"Rayman","year":"2009","journal-title":"Int J Dent Hyg"},{"key":"2025121400474657000_9.3.e024376.16","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1111\/jcpe.12455","article-title":"Occurrence and risk indicators of medication-related osteonecrosis of the jaw after dental extraction: a systematic review and meta-analysis","volume":"42","author":"Gaudin","year":"2015","journal-title":"J Clin Periodontol"},{"key":"2025121400474657000_9.3.e024376.17","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-016047","article-title":"Attitudes and perceptions of GPs and community pharmacists towards their role in the prevention of bisphosphonate-related osteonecrosis of the jaw: a qualitative study in the North East of England","volume":"7","author":"Sturrock","year":"2017","journal-title":"BMJ Open"},{"key":"2025121400474657000_9.3.e024376.18","doi-asserted-by":"crossref","unstructured":"Glaser BG , Strauss AL . The discovery of grounded theory: strategies for qualitative research. Chicago: Aldine, 1967.","DOI":"10.1097\/00006199-196807000-00014"},{"key":"2025121400474657000_9.3.e024376.19","doi-asserted-by":"publisher","DOI":"10.1023\/A:1020909529486"},{"key":"2025121400474657000_9.3.e024376.20","doi-asserted-by":"crossref","unstructured":"Ritchie J , Spencer L . Qualitative data analysis for applied policy research. In: Humberman M , Miles M , eds. The qualitative researcher\u2019s companion. Thousand Oaks: Sage, 2002:305\u201329.","DOI":"10.4135\/9781412986274.n12"},{"key":"2025121400474657000_9.3.e024376.21","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2010-0183"},{"key":"2025121400474657000_9.3.e024376.22","first-page":"175","article-title":"The knowledge and attitudes of North Wales healthcare professionals to bisphosphonate associated osteochemonecrosis of the jaws","volume":"10","author":"Masson","year":"2009","journal-title":"J Disab Oral Health"},{"key":"2025121400474657000_9.3.e024376.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2011.04.011"},{"key":"2025121400474657000_9.3.e024376.24","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1038\/sj.bdj.2017.784","article-title":"Oral health promotion in the community pharmacy: an evaluation of a pilot oral health promotion intervention","volume":"223","author":"Sturrock","year":"2017","journal-title":"Br Dent J"},{"key":"2025121400474657000_9.3.e024376.25","unstructured":"Pharmaceutical Services Negotiating Committee. Medicines use review. http:\/\/psnc.org.uk\/services-commissioning\/advanced-services\/murs\/ (Accessed 2 Apr 2018)."},{"key":"2025121400474657000_9.3.e024376.26","unstructured":"Pharmaceutical Services Negotiating Committee. New medicines service. http:\/\/psnc.org.uk\/services-commissioning\/advanced-services\/nms\/ (Accessed 2 Apr 2018)."},{"key":"2025121400474657000_9.3.e024376.27","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1038\/sj.bdj.2016.853","article-title":"Interprofessional working: a spearhead opportunity for dentistry and pharmacy","volume":"221","author":"Wilson","year":"2016","journal-title":"Br Dent J"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-024376","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:47:55Z","timestamp":1765702075000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-024376"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,3]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bmjopen-2018-024376"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-024376","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}