Outcome evaluation of osteoporosis patient education: an observational study comparing an intervention group and...

Osteoporosis patient education has not been evaluated across Danish municipalities. In this observational study, we compared patients who had participated in osteoporosis patient education with patients who had not. We found differences both in favor of patient education and no patient education, and therefore, conclusions regarding effectiveness cannot be drawn based on this study design.

Osteoporosis patients may benefit from patient education, including knowledge dissemination and physical exercises. We examined two primary outcomes: fractures and quality of life as well as eight secondary outcomes (self-efficacy, physical activity, balance, falls, adherence, pain management, psychological wellbeing, and daily functional capacity).

We retrieved data from 15 Danish municipalities on citizens who had participated in osteoporosis patient education between 2016 and 2020. These were matched with citizens who had not participated (1:1) on gender, age, time of osteoporosis diagnosis, and type of previous osteoporotic fractures. A questionnaire was sent out and register data was retrieved, on average 3.7 years after participation in patient education. Participants were compared to controls using logistic or linear regression.

We included a total of 3132 individuals; 1660 answered the questionnaire. We found that participants had a lower score on the physical component of quality of life (difference -1.28; 95% CI -2.29, -0.28) and were more worried about falling compared to controls (OR 1.61; 95% CI 1.31, 1.99). Participants had more active spare time (OR 0.59; 95% CI 0.44, 0.81), performed more bone-specific physical activities (difference 0.50; 95% CI 0.01, 0.99), and were more adherent to medication (OR 1.74; 95% CI 1.49, 2.03). All other outcomes showed no statistically significant differences.

Our findings show that citizens who participated in patient education were more adherent to medication. Results related to quality of life, physical activity, and fear of falling were inconclusive, and therefore, we cannot draw conclusions regarding the overall effectiveness of osteoporosis patient education. Further studies should include baseline measurements and preferably conduct randomized controlled trials.