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Effectiveness of patient education for patients with osteoporosis: a systematic review

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Abstract

Summary

In this systematic review, the effects of osteoporosis patient education were examined. All studies found an effect on physical function, but for the other themes, the results were inconclusive. The findings indicate a need for further research in this topic.

Introduction

Osteoporosis is a chronic disease with serious consequences for the individual and major societal costs. With the aim of fracture prevention, many countries offer osteoporosis patient education. The objectives were to examine the effects and mediators of osteoporosis patient education and describe the characteristics of studies with and without an effect. Though, none of the included studies reported mediators, and therefore, we could not examine that.

Methods

Six databases were searched in October 2020. Two researchers independently conducted title and abstract screening as well as full-text review. Records were included if participants had osteoporosis, and the patient education was group-based, face-to-face, and addressed two or more aspects, e.g., diet, medication, and exercise. The Cochrane Collaboration tools were used for risk of bias assessment. Finally, data were extracted into a standardized form and presented narratively.

Results

In total, 2934 records were identified, and 13 studies met the inclusion criteria. All six studies examining the effects of patient education on physical function demonstrated improvements. In addition, one out of two RCT studies and one non-randomized study reported improved psychological wellbeing. Just one out of five RCT studies showed improvements regarding physical discomfort and disability. Effects on health-related quality of life, adherence and persistence, and knowledge of osteoporosis were inconclusive.

Conclusion

There is limited evidence for the effectiveness of osteoporosis patient education. There is a need for high-quality randomized controlled trials, which should describe the characteristics of the interventions and examine the mechanisms of osteoporosis patient education.

PROSPERO registration number

CRD42020211930

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Availability of data and material

The search string is provided in Online Resource 1. Records excluded due to time limit are provided in Online Resource 2, and tables with outcome measurements and results are in Online Resource 3.

Code availability

Not applicable.

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Acknowledgements

The authors would like to thank Simon Humeniuk Esrup for his assistance with the title and abstract screening and Magnus Grønlund Bendtsen for assisting with the risk of bias assessment.

Funding

The research was supported by National Research Center for Bone Health, Zealand University Hospital and National Institute of Public Health, University of Southern Denmark.

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Authors and Affiliations

  1. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark

    M. Rubæk, T. Holmberg & S. Andersen

  2. National Research Center for Bone Health, Zealand University Hospital, Køge, Denmark

    M. Rubæk, M. F. Hitz & B. M. T. Schønwandt

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  1. M. Rubæk
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Correspondence to M. Rubæk.

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Conflicts of interest

Mette Friberg Hitz has received grants from Orkla Care, Denmark, UCB, Ellab Fond, and Amgen and received personal payment in relation to lectures and advisory board meetings. Mette Rubæk, Teresa Holmberg, Bodil Marie Thuesen Schønwandt, and Susan Andersen declare that they have no conflict of interest.

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Rubæk, M., Hitz, M.F., Holmberg, T. et al. Effectiveness of patient education for patients with osteoporosis: a systematic review. Osteoporos Int 33, 959–977 (2022). https://doi.org/10.1007/s00198-021-06226-5

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