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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.
Citation:

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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