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The impact of educational interventions on modifiable risk factors for osteoporosis after a fragility fracture

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Abstract

The purpose of this study was to investigate the impact of two educational interventions on the intake of calcium and vitamin D supplements and modifiable risk factors for osteoporosis in women ≥50 years with a fragility fracture (FF). Within 6–8 months of fracture, women were randomized to one of three intervention groups: usual care (UC), written materials (WM), or videocassette and written materials (VC). The written materials for patients and their physician provided information on osteoporosis, FF, and available treatments; written materials for physician were provided through patients. The videocassette presented similar information as the written material, but in greater depth. Twelve months after randomization, the effectiveness of the interventions was assessed. The study cohort consisted of 1,175 women undiagnosed and untreated for osteoporosis. After 12 months, the mean intake of Ca supplements increased by 33, 93, and 91 mg/day for the UC, WM, and VC groups, respectively (p value, WM vs UC = 0.163; VC vs UC = 0.026); the corresponding mean increases for vitamin D were 58, 105, and 118 IU/day (p value, WM vs UC = 0.214; VC vs UC = 0.012). The proportion of women who increased their Ca and vitamin D intake by supplements was similar in all three groups. The intervention had a greater impact in those not taking supplements at randomization and had no impact on modifiable risk factors. In women without diagnosis and treatment for osteoporosis, the interventions seem effective at increasing the amounts of Ca and vitamin D supplements, but not effective at inciting more women to increase their consumption. Therefore, the clinical significance of the impact of the intervention is difficult to evaluate.

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Acknowledgments

We gratefully acknowledge the contributions of the ROCQ Program staff, particularly the program coordinators Nathalie Migneault and Lucie Vaillancourt and the 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, and 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, and 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 the past members of the ROCQ executive, Louise Lafortune, Christine Chin, Luc Sauriol, and Andy McClenaghan, for their insightful guidance and all CaMos investigators for allowing us to utilize pertinent sections of the CaMos questionnaires for ROCQ. Lastly, we thank Dr. Corey Toal for providing editorial assistance.

Conflicts of interest

C Beaudoin has no conflict of interest to disclose.

L Bessette has received remuneration from Amgen, Eli Lilly, Novartis, and Merck; consultant/advisory role to Amgen, UCB, Pfizer, Abbvie, and Hoffmann-La Roche; and funds from Abbott, Amgen, Bristol-Myers Squibb, Eli Lilly, Merck, Novartis, Pfizer, Roche, Sanofi-aventis, Servier, Warner Chilcott, and Takeda.

S Jean has no conflict of interest to disclose.

L-G Ste-Marie has received remuneration from Alliance for better bone health (Warner Chilcott and Sanofi-aventis Canada Inc.), Amgen, Novartis, Eli Lilly, Servier, Merck, and Paladin; consultant/advisory role to Eli Lilly, Amgen, Merck, Novartis, Paladin, Alliance for better bone health, and Servier; and funds from Alliance for better bone health, Amgen, Novartis, Eli Lilly, Servier, and Genzyme.

J P Brown has received remuneration from Amgen, Eli Lilly, Merck, and Warner Chilcott; consultant/advisory role to Amgen, Eli Lilly, and Merck; and funding from Amgen, Bristol-Myers Squibb, Eli Lilly, Novartis, Merck, Pfizer, Roche, Servier, Sanofi-aventis, Takeda, and Warner Chilcott.

The ROCQ program was funded by Merck Canada, Inc., Warner Chilcott PLC, Sanofi-Aventis Group, Eli Lilly Canada, Inc., Novartis Pharmaceuticals Canada, Inc., and Amgen 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.

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Beaudoin, C., Bessette, L., Jean, S. et al. The impact of educational interventions on modifiable risk factors for osteoporosis after a fragility fracture. Osteoporos Int 25, 1821–1830 (2014). https://doi.org/10.1007/s00198-014-2618-4

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  • DOI: https://doi.org/10.1007/s00198-014-2618-4

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