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Promoting bone health management in women diagnosed with breast cancer: a pilot randomized controlled trial

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Abstract

Summary

This study investigates, in women diagnosed with breast cancer, the feasibility of evaluating the effects of educational material and its delivery method, on bone health management. The study results suggest educational material may improve rates of bone mineral density testing.

Introduction

Educational materials improve bone mineral density (BMD) testing rates in high-risk patients, but the effect is unknown in women diagnosed with breast cancer. Methods of delivering educational materials may also affect testing rates. The purposes of this study were to determine the feasibility of the protocol and to pilot-test the effects of educational material and its delivery methods on BMD testing rates.

Method

Pilot randomized controlled trial with block randomization. Fifty-four women (aged 65–75 and diagnosed with breast cancer ≥ 3 years ago (2010–2012) and not taking osteoporosis medication) were recruited from February to May 2016 and randomized to three groups: control without educational material, educational material delivered by postal mail, and educational material delivered by patient choice of postal mail, email, or text messaging. Outcome measures were primarily evaluated using self-report questionnaires.

Results

The participation rate, defined as the proportion of eligible participants who consented to participate, was 39.1%. Primary outcome measure was obtained for 98% of the recruited women. During the 6-month follow-up period, BMD testing rates were significantly higher in the groups receiving educational materials by mail (26%, 95%CI = 10 to 49) and by patient choice (18%, 95%CI = 5 to 41), when compared with the control group (6%, 95%CI = 0.3 to 25). Educational material was associated with a 17% higher BMD testing rate.

Conclusions

The study protocol is feasible for a large-scale study. The educational material intervention is broadly accepted by the study participants with a promising positive effect on BMD testing rates.

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Abbreviations

BC :

British Columbia

BMD :

Bone Mineral Density

CAT :

Calcium Assessment Tool

CI :

Confidence Interval

DXA :

Dual energy X-ray absorptiometry

FRAX :

Fracture risk assessment tool

GLTEQ :

Godin Leisure-Time Exercise Questionnaire

RCT :

Randomized Controlled Trial

SD :

Standard deviation

VIDSUN :

Vitamin D & Sun

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Acknowledgments

The authors thank pharmacist Jin Qing Pan for reviewing medication dispensing records and the Centre of Excellence in Cancer Prevention, a partnership between the Canadian Cancer Society and the University of British Columbia’s School of Population and Public Health, for facilitating development of the educational material. The first author, Dr. Olivia L. Tseng, was financially supported by a Clinician Scholarship through the Department of Family Practice of University of British Columbia and a Roman M. Babicki Fellowship in Medical Research through the University of British Columbia.

Funding

This study was supported by Janus research Award from the College of Family Physicians Canada.

Author information

Authors and Affiliations

  1. Cancer Control Research Program, British Columbia Cancer Agency (BCCA), Vancouver, BC, Canada

    Olivia L. Tseng, John J. Spinelli, Carolyn C. Gotay & Mary L. McBride

  2. Department of Family Practice, University of British Columbia, Vancouver, BC, Canada

    Olivia L. Tseng & Martin G. Dawes

  3. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    John J. Spinelli, Carolyn C. Gotay & Mary L. McBride

  4. Faculty of Pharmaceutical Science, University of Britissh Columbia, Vancouver, BC, Canada

    Wan Yu Ho

Authors
  1. Olivia L. Tseng
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  2. John J. Spinelli
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  4. Wan Yu Ho
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Corresponding author

Correspondence to Olivia L. Tseng.

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Ethical approval

This study has been approved by the University of British Columbia/BC Cancer Agency Ethics Board (H15-00849).

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None.

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Tseng, O.L., Spinelli, J.J., Gotay, C.C. et al. Promoting bone health management in women diagnosed with breast cancer: a pilot randomized controlled trial. Arch Osteoporos 13, 52 (2018). https://doi.org/10.1007/s11657-018-0469-x

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