A systematic review of interventions by healthcare professionals on community-dwelling postmenopausal women with osteoporosis
- 514 Downloads
A systematic review was conducted to evaluate evidence concerning the effect of non-drug interventions by healthcare professionals on community-dwelling postmenopausal osteoporotic women. Evidence available indicates that such interventions are effective in improving the quality of life, medication compliance, and calcium intake, but effect on other outcomes is less conclusive.
The purpose of this study is to conduct a systematic review to evaluate evidence concerning the effect of non-drug interventions by healthcare professionals on community-dwelling postmenopausal osteoporotic women.
Randomized controlled trials (RCTs) published in English between year 1990 and 2009 were identified. Types of patient outcome used as assessment included quality of life (QOL), bone mineral density (BMD), medication compliance and persistence, knowledge level, and lifestyle modification.
Twenty four RCTs met the inclusion criteria. Seven studies assessed interventions by physiotherapists, six by physicians, seven by nurses, three by multi-disciplinary teams and one by dietitians. Variability in the types and intensity of interventions made comparison between each study difficult. Collectively, these studies provided some evidence to show that interventions by healthcare professionals improved the QOL medication compliance and calcium intake of patients but its effects on BMD, medication persistence, knowledge, and other lifestyle modifications were less conclusive.
From this review, it was found that some outcome measures of such non-drug interventions still required further studies. Future studies should use validated instruments to assess the outcomes, with focus on common definitions of interventions and outcome measures, more intensive one-to-one interventions, appropriate control groups, adequate randomization procedures, and also provide information on effect size.
KeywordCommunity-dwelling Healthcare professionals Interventions Postmenopausal Systematic review
Conflicts of interest
- 6.Scottish Intercollegiate Guidelines Network (2008) "Section 6: Systematic literature review. http://www.sign.ac.uk/guidelines/fulltext/50/section6.html. Accessed 3 Oct 2008
- 7.Agency for Healthcare Research and Quality. (2001). "Outcomes research: Fact sheet." http://www.ahrq.gov/clinic/outfact.htm. Accessed 3 Oct 2008
- 8.University of Colorado. (2000). "Effect size." http://web.uccs.edu/lbecker/Psy590/es.htm. 31 July 2009
- 9.Cohen J (1988) Statistical power analysis for the behavioural sciences. Lawrence Earlbaum Associates, HillsdaleGoogle Scholar
- 38.Kim KK, Horan ML, Gendler P (1991) Osteoporosis knowledge tests, osteoporosis health belief scale, and osteoporosis self-efficacy scale. Grand Valley State University, AllendaleGoogle Scholar
- 42.Koval PG, Easterling L, Pettus D et al (2005) How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis? J Fam Pract 54(65):69–71Google Scholar
- 46.National Osteoporosis Foundation (2003) Physician's guide to prevention and treatment of osteoporosis. www.nof.org. 24 Aug 2009
- 47.Trimpou P, Bosaeus I, Bengtsson BA et al (2009) High correlation between quantitative ultrasound and DXA during 7 years of follow-up. Eur J Radiol. doi: 10.1016/j.ejrad.2008.11.024
- 50.Faulkner K (1995) Measurement of axial and peripheral bone mass by QCY. Bone mass measurement in osteoporosis and other bone diseases. http://www.qct.com/Media/Experts.pdf. 14 Aug 2009