Results of Patient Education about Osteoporosis after Fragility Fracture: Osteoporosis Knowledge
Of the 23 patients who completed the OPQ at baseline, 22 also completed it at follow-up. One patient declined to do so because he could not remember having had the educational intervention while in hospital. The osteoporosis knowledge assessment scores based on intention-to-treat patient numbers (n = 23) are presented in Table 3.
At baseline, 22 patients (95%) had heard of osteoporosis. Most had heard of the condition from friends, family, and the media, but only 4 (17%) had discussed osteoporosis with their doctor or another health care professional. At baseline, 18 patients (78%) knew the correct definition of osteoporosis, whereas 21 (91%) knew the definition at follow-up (p = 0.04). At baseline, 16 patients (70%) knew that adequate calcium and vitamin D intake were needed to maintain healthy bones, and 22 (96%) knew this at follow-up (p = 0.12).
The mean score increased from 7.3 out of 20 (range 0 to 17, SD 4.98) at baseline to 11.6 out of 20 (range 6 to 20, SD 4.92) at follow-up (p < 0.001).
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Table 3. Osteoporosis Knowledge Scores at Baseline and Follow-up among 23 Patients with Fragility Fracture
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Attempt to Identify and Manage Osteoporosis
Before the educational intervention, only 4 patients (17%) remembered having had a discussion with theirphysician or another health care professional about osteoporosis, whereas 10 patients (43%) discussed their risks for osteoporosis with a physician after the intervention (p = 0.024). Of these 10 patients, 7 went on to have a BMD scan performed or scheduled. Four of the 7 patients were undergoing BMD scanning for the first time. All of the scans were ordered by the family physician. Two patients who had a scan performed or scheduled were also started on osteoporosis drug therapy. Of the 3 patients who spoke to their physician but did not have a BMD scan performed or scheduled, one had started osteoporosis treatment. In total, 9 patients (39%) were receiving antiresorptive medications for osteoporosis management or prevention at baseline and 12 (52%) patients were receiving such therapy at follow-up (p < 0.001, chi-square test).
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Table 4. Hospital Assessment for Osteoporosis (n = 23)
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Secondary Outcome
Because all participants had a clinically defined fragility fracture, they met the criteria of the 2002 Canadian clinical practice guidelines for assessment of osteoporosis. During the hospital visit, no patients were investigated for osteoporosis with a BMD scan or any other method (Table 4). For 4 patients (17%), osteoporosis treatment was ordered in hospital as a continuation of home therapy, but none had new osteoporosis treatment initiated. No patients were referred for osteoporosis assessment upon discharge. Only one patient had calcium and vitamin D ordered in the hospital as a continuation of home therapy. No patients left the hospital with a new diagnosis of osteoporosis.
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