Clinical Edge

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Challenges of Patient-Activated Osteoporosis Care

J Bone Miner Res; ePub 2018 Jan 26; Danila, et al

Achieving changes in osteoporosis care using patient activation approaches alone is challenging, according to a recent study. Researchers conducted a parallel group, controlled, randomized clinical trial evaluating a behavioral intervention for improving osteoporosis medication use. 2,684 women with self-reported fracture history after age 45 not using osteoporosis therapy from US Global Longitudinal study of Osteoporosis in Women (GLOW) sites were randomized 1:1 to receive a multi-modal, tailored, direct-to-patient, video intervention vs usual care. They found:

  • In intent-to-treat analyses, there were no significant differences between groups (intervention vs control) in osteoporosis medication use, calcium supplementation, vitamin D intake, or BMD testing.
  • In the intervention group, fewer women were in the pre-contemplative stage of behavior change, more women reported seeing their primary care provider, had concerns regarding osteonecrosis of the jaw, and difficulty in taking/remembering to take osteoporosis medications.
  • There were differences in BMD testing among the subgroup of women with no prior osteoporosis treatment, those who provided contact information, and those with no past BMD testing.

Danila MI, Outman RC, Rahn EJ, et al. Evaluation of a multi-modal, direct-to-patient educational intervention targeting barriers to osteoporosis: A randomized clinical trial. [Published online ahead of print January 26, 2018]. J Bone Miner Res. doi:10.1002/jbmr.3395.

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