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Erschienen in: Osteoporosis International 7/2014

01.07.2014 | Review

The impact of educational interventions on modifiable risk factors for osteoporosis after a fragility fracture

verfasst von: C. Beaudoin, L. Bessette, S. Jean, L.-G. Ste-Marie, J. P. Brown

Erschienen in: Osteoporosis International | Ausgabe 7/2014

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Abstract

The purpose of this study was to investigate the impact of two educational interventions on the intake of calcium and vitamin D supplements and modifiable risk factors for osteoporosis in women ≥50 years with a fragility fracture (FF). Within 6–8 months of fracture, women were randomized to one of three intervention groups: usual care (UC), written materials (WM), or videocassette and written materials (VC). The written materials for patients and their physician provided information on osteoporosis, FF, and available treatments; written materials for physician were provided through patients. The videocassette presented similar information as the written material, but in greater depth. Twelve months after randomization, the effectiveness of the interventions was assessed. The study cohort consisted of 1,175 women undiagnosed and untreated for osteoporosis. After 12 months, the mean intake of Ca supplements increased by 33, 93, and 91 mg/day for the UC, WM, and VC groups, respectively (p value, WM vs UC = 0.163; VC vs UC = 0.026); the corresponding mean increases for vitamin D were 58, 105, and 118 IU/day (p value, WM vs UC = 0.214; VC vs UC = 0.012). The proportion of women who increased their Ca and vitamin D intake by supplements was similar in all three groups. The intervention had a greater impact in those not taking supplements at randomization and had no impact on modifiable risk factors. In women without diagnosis and treatment for osteoporosis, the interventions seem effective at increasing the amounts of Ca and vitamin D supplements, but not effective at inciting more women to increase their consumption. Therefore, the clinical significance of the impact of the intervention is difficult to evaluate.
Literatur
1.
Zurück zum Zitat Papaioannou A, Kennedy CC, Ioannidis G, Sawka A, Hopman WM, Pickard L, Brown JP, Josse RG, Kaiser S, Anastassiades T, Goltzman D, Papadimitropoulos M, Tenenhouse A, Prior JC, Olszynski WP, Adachi JD (2008) The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study. Osteoporos Int 20:703–714PubMedCrossRef Papaioannou A, Kennedy CC, Ioannidis G, Sawka A, Hopman WM, Pickard L, Brown JP, Josse RG, Kaiser S, Anastassiades T, Goltzman D, Papadimitropoulos M, Tenenhouse A, Prior JC, Olszynski WP, Adachi JD (2008) The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study. Osteoporos Int 20:703–714PubMedCrossRef
2.
Zurück zum Zitat Ioannidis G, Papaioannou A, Hopman WM, Khtar-Danesh N, Anastassiades T, Pickard L, Kennedy CC, Prior JC, Olszynski WP, Davison KS, Goltzman D, Thabane L, Gafni A, Papadimitropoulos EA, Brown JP, Josse RG, Hanley DA, Adachi JD (2009) Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study. CMAJ 181:265–271PubMedCentralPubMedCrossRef Ioannidis G, Papaioannou A, Hopman WM, Khtar-Danesh N, Anastassiades T, Pickard L, Kennedy CC, Prior JC, Olszynski WP, Davison KS, Goltzman D, Thabane L, Gafni A, Papadimitropoulos EA, Brown JP, Josse RG, Hanley DA, Adachi JD (2009) Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study. CMAJ 181:265–271PubMedCentralPubMedCrossRef
3.
Zurück zum Zitat Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E (2001) Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int 12:271–278PubMedCrossRef Wiktorowicz ME, Goeree R, Papaioannou A, Adachi JD, Papadimitropoulos E (2001) Economic implications of hip fracture: health service use, institutional care and cost in Canada. Osteoporos Int 12:271–278PubMedCrossRef
4.
Zurück zum Zitat Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382PubMedCrossRef Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, Eisman J, Fujiwara S, Garnero P, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382PubMedCrossRef
5.
Zurück zum Zitat Brown JP, Josse RG (2002) 2002 Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ 167:S1–S34PubMedCentralPubMed Brown JP, Josse RG (2002) 2002 Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ 167:S1–S34PubMedCentralPubMed
6.
Zurück zum Zitat Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B, Siminoski K, Leslie WD (2010) 2010 Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182(17):1864–1873PubMedCentralPubMedCrossRef Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, Hanley DA, Hodsman A, Jamal SA, Kaiser SM, Kvern B, Siminoski K, Leslie WD (2010) 2010 Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ 182(17):1864–1873PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Bessette L, Davison KS, Jean S, Roy S, Ste-Marie LG, Brown JP (2011) The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population based randomized controlled trial. Osteoporos Int 22(12):2963–2972PubMedCrossRef Bessette L, Davison KS, Jean S, Roy S, Ste-Marie LG, Brown JP (2011) The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population based randomized controlled trial. Osteoporos Int 22(12):2963–2972PubMedCrossRef
8.
Zurück zum Zitat Bessette L, Ste-Marie LG, Jean S, Davison KS, Beaulieu M, Baranci M, Bessant J, Brown JP (2008) Recognizing osteoporosis and its consequences in Quebec (ROCQ): background, rationale, and methods of an anti-fracture patient health-management programme. Contemp Clin Trials 29:194–210PubMedCrossRef Bessette L, Ste-Marie LG, Jean S, Davison KS, Beaulieu M, Baranci M, Bessant J, Brown JP (2008) Recognizing osteoporosis and its consequences in Quebec (ROCQ): background, rationale, and methods of an anti-fracture patient health-management programme. Contemp Clin Trials 29:194–210PubMedCrossRef
9.
Zurück zum Zitat Kreiger N, Tenenhouse A, Joseph L, Mackenzie T, Poliquin S, Brown J, Prior J, Rittmaster R (1999) The Canadian Multicentre Osteoporosis Study (CaMos): background, rationale, methods. Can J Aging 18:376–387CrossRef Kreiger N, Tenenhouse A, Joseph L, Mackenzie T, Poliquin S, Brown J, Prior J, Rittmaster R (1999) The Canadian Multicentre Osteoporosis Study (CaMos): background, rationale, methods. Can J Aging 18:376–387CrossRef
11.
Zurück zum Zitat Gold DT, Silverman SL (2004) Osteoporosis self-management: choices for better bone health. South Med J 97(6):551–554PubMedCrossRef Gold DT, Silverman SL (2004) Osteoporosis self-management: choices for better bone health. South Med J 97(6):551–554PubMedCrossRef
12.
Zurück zum Zitat Cranney A, Lam M, Ruhland L, Brison R, Godwin M, Harrison MM, Harrison MB, Anastassiades T, Grimshaw JM, Graham ID (2008) A multifaceted intervention to improve treatment of osteoporosis in postmenopausal women with wrist fractures: a cluster randomized trial. Osteoporos Int 19(12):1733–1740PubMedCrossRef Cranney A, Lam M, Ruhland L, Brison R, Godwin M, Harrison MM, Harrison MB, Anastassiades T, Grimshaw JM, Graham ID (2008) A multifaceted intervention to improve treatment of osteoporosis in postmenopausal women with wrist fractures: a cluster randomized trial. Osteoporos Int 19(12):1733–1740PubMedCrossRef
13.
Zurück zum Zitat Davis JC, Guy P, Ashe MC, Liu-Ambrose T, Khan K, Davis JC, Guy P, Ashe MC, Liu-Ambrose T, Khan K (2007) HipWatch: osteoporosis investigation and treatment after a hip fracture: a 6-month randomized controlled trial. J Gerontol Ser A Biol Sci Med Sci 62(8):888–891CrossRef Davis JC, Guy P, Ashe MC, Liu-Ambrose T, Khan K, Davis JC, Guy P, Ashe MC, Liu-Ambrose T, Khan K (2007) HipWatch: osteoporosis investigation and treatment after a hip fracture: a 6-month randomized controlled trial. J Gerontol Ser A Biol Sci Med Sci 62(8):888–891CrossRef
14.
Zurück zum Zitat Feldstein A, Elmer PJ, Smith DH, Herson M, Orwoll E, Chen C, Aickin M, Swain MC (2006) Electronic medical record reminder improves osteoporosis management after a fracture: a randomized, controlled trial. J Am Geriatr Soc 54(3):450–457PubMedCrossRef Feldstein A, Elmer PJ, Smith DH, Herson M, Orwoll E, Chen C, Aickin M, Swain MC (2006) Electronic medical record reminder improves osteoporosis management after a fracture: a randomized, controlled trial. J Am Geriatr Soc 54(3):450–457PubMedCrossRef
15.
Zurück zum Zitat Kulp JL, Rane S, Bachmann G (2004) Impact of preventive osteoporosis education on patient behavior: immediate and 3-month follow-up. Menopause 11:116–119PubMedCrossRef Kulp JL, Rane S, Bachmann G (2004) Impact of preventive osteoporosis education on patient behavior: immediate and 3-month follow-up. Menopause 11:116–119PubMedCrossRef
16.
Zurück zum Zitat Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR (2010) Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 341:c3691PubMedCentralPubMedCrossRef Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR (2010) Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 341:c3691PubMedCentralPubMedCrossRef
Metadaten
Titel
The impact of educational interventions on modifiable risk factors for osteoporosis after a fragility fracture
verfasst von
C. Beaudoin
L. Bessette
S. Jean
L.-G. Ste-Marie
J. P. Brown
Publikationsdatum
01.07.2014
Verlag
Springer London
Erschienen in
Osteoporosis International / Ausgabe 7/2014
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-014-2618-4

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