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The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population-based randomized controlled trial

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Abstract

Summary

This study assessed whether osteoporosis diagnosis and treatment after an osteoporotic fracture can be increased by providing osteoporosis reading material to patients and family doctors or by watching a videocassette about osteoporosis. Educating patients about osteoporosis had little impact on whether a woman received an osteoporosis diagnosis or treatment.

Introduction

The purpose of this study was to investigate the impact of two education-based interventions on osteoporosis diagnosis and treatment in women ≥50 years of age after fragility fracture.

Methods

Six to eight months after fracture, women were randomized into three groups: (1) control, (2) written materials, or (3) videocassette and written materials. Written materials for both the patient and physician detailed osteoporosis, fragility fracture, and available treatments; written materials for physicians were provided through patients. The educational videocassette presented similar information as the written material, but in greater depth. Rates of osteoporosis diagnosis and treatment following intervention were compared among groups using survival analysis methods. Statistical significance was set at p < 0.0167.

Results

At randomization, 1,174 women were without osteoporosis diagnosis and treatment, and after follow-up, 12% of the control group, 15% of the written materials group (p = 0.073), and 16% (p = 0.036) of the videocassette and written materials group were diagnosed with osteoporosis (statistical comparisons to control). Treatment rates were 8% for the control group, 12% for the written materials group (p = 0.052), and 11% for the videocassette and written materials group (p = 0.157). At randomization, 1,314 women were without treatment and after follow-up therapy was initiated in 10% of the control group, 13% of the written materials group (p = 0.107), and 13% of the videocassette and written materials group (p = 0.238).

Conclusions

The educational interventions assessed in this trial were not satisfactory to increase osteoporosis diagnosis or treatment in recently fractured women to a clinically meaningful degree.

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Acknowledgments

We gratefully acknowledge the contributions of the ROCQ program staff, particularly program coordinators Nathalie Migneault and Lucie Vaillancourt and administrative assistant Julie Parrot. We also acknowledge the contributions of the regional coordinators and research assistants: Sylvie Bélanger, Geneviève Corneau, Isabel Lajeunesse, Pierre-Antoine Landry, Lise Lemire, Anne-Marie Louis XVI, Julie Simard, and Lyse Roy; the Office Clerks: Huguette Bédard, Kateri Bisson, Isabelle Bourque, Alexandre Brown, Marie-Hélène Brown, Francine Lavoie, Vanessa Poulin, Catherine Richard; and the interviewers: Lina Bélisle, Francine Bilodeau, Ginette David, Janot Dumont, Susie Gagnon, Ghislaine Fortin, Louise Groleau, Denise Hubert-Milot, Michèle Paris, Edith Picard-Marcoux, Lucie Riou. Finally, we thank the Regional Directors of this program: Dr. Pierre Dagenais (University of Montreal, Montreal), Dr. Kim Latendresse (University of Montreal, Montreal), Dr. Pierre Major (University of Montreal, Montreal), Dr. Frédéric Morin (Centre Hospitalier Régional deTrois-Rivières, Trois-Rivières), Dr. Suzanne Morin (McGill University, Montreal), and Dr. Josée Villeneuve (Laval University, Quebec City) for their support during the implementation of the program and their critical scientific advice. We also thank past members of the ROCQ executive, Louise Lafortune, Christine Chin, Luc Sauriol, and Andy McClenaghan, for their insightful guidance. Lastly, we appreciate all CaMos investigators for allowing us to utilize pertinent sections of the CaMos questionnaires for ROCQ.

Conflicts of interest

Dr. Bessette has received research grants from Abbott, Amgen, Bristol-Myers-Squibb, Eli Lilly, Merck, Pfizer, and Roche, has received consulting fees or other remuneration from Abbott, Amgen, Merck, Novartis, Pfizer, and Roche and has participated on the speakers bureau for Amgen, Novartis, Merck, Pfizer, Roche, and Warner Chilcott.

Dr. Brown has received research grants from Abbott, Amgen, Bristol-Myers-Squibb, Eli Lilly, Pfizer, and Roche, has received consulting fees or other remuneration from Abbott, Amgen, Eli Lilly, Novartis, Merck, and Warner Chilcott and has participated on the speakers bureau for Eli Lilly, Amgen, Novartis, Merck, and Warner Chilcott.

Dr. Davison has received consulting fees or other remuneration from Amgen and Servier and has participated on the Speakers’ Bureau for Amgen, Merck Frosst Warner Chilcott and Servier.

Dr. Ste-Marie has received research grants from the Alliance for Better Bone Health and Novartis, has received consulting fees or other remuneration from the Alliance for Better Bone Health, Amgen, Novartis, Eli Lilly, and Servier and has participated on the Speakers’ Bureau for the Alliance for Better Bone Health, Amgen, Novartis, Eli Lilly, Servier, and Merck. No other authors have a conflict or interest to disclose

The ROCQ program was funded by Merck Frosst Canada, Inc., Warner Chilcott, sanofi-aventis group, Amgen Canada Inc., Eli Lilly Canada, Inc., and Novartis Pharmaceuticals Canada, Inc. None of the funding sources had a role in the collection, analysis, or interpretation of the data or in the decision to publish this article.

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Authors and Affiliations

  1. Department of Medicine, CHUL Research Centre, Laval University, Quebec City, PQ, Canada

    L. Bessette, K. S. Davison & J. P. Brown

  2. Institut national de santé publique du Québec, Quebec City, PQ, Canada

    S. Jean & S. Roy

  3. University of Montreal, Montreal, PQ, Canada

    L. G. Ste-Marie

  4. 2705, Laurier Boulevard, Room S-763, Quebec City, PQ, Canada, GIV 4G2

    L. Bessette

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  1. L. Bessette
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  5. L. G. Ste-Marie
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Correspondence to L. Bessette.

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Bessette, L., Davison, K.S., Jean, S. et al. The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population-based randomized controlled trial. Osteoporos Int 22, 2963–2972 (2011). https://doi.org/10.1007/s00198-011-1533-1

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