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Effective Osteoporosis Education in the Outpatient Orthopaedic Setting

¹ Department of Orthopaedic Surgery, George Washington University, 2150 Pennsylvania Avenue N.W., 7th Floor, Washington, DC 20037. E-mail address for J.E. Schulman: schulmje{at}yahoo.com
² Department of Orthopaedic Surgery, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267-0212
³ Department of Orthopaedic Surgery, LSU-HSC Medical Center, 1501 Kings Highway, Shreveport, LA 71103

Investigation performed at George Washington University, Washington, DC

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).

Methods: Eighty female patients ranging from fifteen to seventy-three years of age completed an eleven-question quiz that included items regarding their knowledge of osteoporosis, calcium intake, menopausal status, exercise, smoking, and whether or not they had had a bone mineral density scan. The quiz was completed during a visit to an outpatient sports medicine/general orthopaedic clinic. After the quiz, an educational intervention was performed by providing the patients with an informational handout. The patients were followed at an average interval of six months and were reassessed either in the office or over the telephone with use of the same quiz to evaluate increases in knowledge and modification of lifestyle.

Results: Fifty-four premenopausal and twenty-six postmenopausal patients were available for follow-up. The premenopausal and postmenopausal groups differed at the beginning of the study, with premenopausal patients having a higher daily calcium intake (p = 0.008) and a better ability to define osteoporosis (p = 0.004) and postmenopausal patients having a higher rate of having had a prior bone mineral density scan (p < 0.001). In response to the educational intervention, significant improvements were seen in terms of the patients' ability to define osteoporosis (p = 0.004), the ability to identify being female as a major risk factor (p < 0.001), and the understanding that females should begin adequate calcium intake at a young age (p < 0.001). Significant increases in daily calcium intake (p < 0.001) and exercise level also occurred (p < 0.003). The postmenopausal group demonstrated a less robust response to the educational intervention.

Conclusions: The outpatient orthopaedic sports medicine office setting represents a prime opportunity for education regarding osteoporosis prevention and lifestyle modification that can be performed in an inexpensive fashion and that can be easily replicated in most offices both in the community and in academic settings.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

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This article has been cited by other articles:

				A. S. Hilibrand, K. P. Spindler, and S. D. Boden AOA Symposium. Orthopaedists Partnering with Other Physicians to Provide Musculoskeletal Care J. Bone Joint Surg. Am., December 1, 2007; 89(12): 2810 - 2818. [Full Text] [PDF]

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