This article is more than 5 years old. Information may no longer be current.
Video intervention increases non-bisphosphonate use in select postmenopausal women
Older white women with a history of fracture who viewed tailored videos on the importance of osteoporosis treatment were more likely to report initiating non-bisphosphonate therapy in the 6 and 18 months after the intervention vs. women who received usual care, according to findings published in the Journal of Bone and Mineral Research.
“Despite medications that lower fracture risk at some sites by more than 50% and guidelines endorsing the need for treatment following a fracture, many fragility fracture patients fail to receive osteoporosis treatment and do not associate their fracture with osteoporosis,” Maria I. Danila, MD, MSc, MSPH, of the University of Alabama at Birmingham, and colleagues wrote in the study background. “Some women consider osteoporosis as benign, do not associate fractures with osteoporosis and view osteoporosis as a natural process of aging. As a result, there is a growing ‘osteoporosis gap.’”
Danila and colleagues analyzed data from 2,684 women aged at least 55 years who self-reported at least one fracture after age 45 years and who were participating in the Activating Patients at Risk for Osteoporosis study, a randomized controlled trial in which patients received either patient-tailored behavioral intervention or usual care (mean age, 75 years; 93% white). Participants completed baseline questionnaires in September 2013 regarding use of osteoporosis medication and dietary supplements, fracture and general health history, and were randomly assigned to personalized, direct-to-patient video intervention, ranging between 5 and 15 minutes, or to usual care. Video vignettes were tailored to participants’ reported race and perceived barriers ranked by participants, including general fears of medications, preference for alternative therapies and concerns about long-term adverse events. Primary outcome was self-report of current osteoporosis medication use at 6 months; secondary outcomes included self-reported initiation of calcium and/or vitamin D supplementation and receipt of bone mineral density testing at 6 months.
In the 6 months after the video intervention, researchers found that 83.7% of women in the intervention group and 80.4% of women in the control group reported seeing their primary care physician (OR = 1.25; 95% CI, 1.21-1.3), whereas 43.4% and 42.7% of intervention and control women, respectively, reported talking with a health care provider about bone health (P = .74).
Researchers did not observe a between-group difference regarding the self-reported use of osteoporosis medications at 6 months (P = .83) or any between-group differences in initiating calcium, vitamin D therapy or undergoing BMD testing. However, women with appreciable exposure to the video intervention were more likely to report starting non-bisphosphonate osteoporosis therapy vs. controls (4.5% vs. 1.8%; OR = 2.7; 95% CI, 1.26-5.79). These results persisted at 18 months after intervention (6.5% vs. 2.7%; OR = 2.54; 95% CI, 1.22-5.29).
Additionally, women with no prior osteoporosis treatment were more likely to report BMD testing at 6 months after participating in the video intervention vs. controls (OR = 1.3; 95% CI, 1.01-1.66), as were women who provided contact information (OR = 1.33; 95% CI, 1.01-1.74) and women who did not report past BMD testing (OR = 1.53; 95% CI, 1.4-1.68).
“Achieving changes in osteoporosis care using patient-activation approaches is challenging,” the researchers wrote. “While our personalized, multi-modal behavioral intervention did not increase the use of osteoporosis therapy at 6 months, it increased non-bisphosphonate medication use and BMD testing in select subgroups, shifted participant’s readiness for behavior change and altered perceptions of common barriers to osteoporosis treatment within exploratory analyses, suggesting future research with similarly designed interventions may merit study when applied to select populations.” – by Regina Schaffer
Disclosures: Danila reports no relevant financial disclosures. Please see the study for the other authors’ relevant financial disclosures.