Bone density testing: an under-utilised and under-researched health education tool for osteoporosis prevention?

Understanding Patients' Perspectives and Educational Needs by Type of Osteoporosis in Men and Women and People with Glucocorticosteroid-Induced Osteoporosis: A Qualitative Study to Improve Disease Management

The aim of the study was to investigate similarities and differences in health beliefs, experiences and educational needs by type of osteoporosis (OP), particularly in people with glucocorticoid-induced OP (GIOP) and men. A qualitative study was conducted via focus groups involving post-menopausal women with or without osteoporotic fractures, osteoporotic men and people with GIOP. Fifty-three participants were included in eight groups. A wide range of health beliefs was found for all types of OP. Osteoporosis was considered a natural consequence of ageing except in men or conversely a serious disease associated with risk of new fractures and disability. GIOP patients had heterogeneous knowledge of OP and reported fewer prevention behaviours, and their quality of life was affected by the causal illness. Men had difficulties coping with the loss of their functional abilities and felt that OP was a "women's" disease. Beliefs about treatments ranged from confidence to fear of adverse effects or doubt about efficacy in all types of OP. Participants were interested in physical activity, fall prevention and diet, and preferred group sessions. GIOP patients and men had an interest in face-to-face education. Men were also interested in brief information including via the Internet. Patients' beliefs about OP differed by type of OP. Specific populations such as men or people with GIOP need particular care owing to experiences and needs. Offering group sessions in educational interventions is of interest to allow for sharing experiences and also face-to-face education for men and GIOP patients or the Internet for men.

Ability of community pharmacists to promote self-care and self-medication by local residents [I]: Improvements in bone mineral density

This study was conducted in order to establish a health management method for the elderly in a community through follow-ups of bone mineral density (BMD) measurement results over a 1-year period based on BMD measurements performed by pharmacists and a guidance program. Regarding BMD measurement results, the percent young adult mean (%YAM: mean BMD in healthy persons of the same sex aged between 51 and 82 years old) significantly increased in Period I, during which the intervention by pharmacists was performed (6 months after the start of measurements), but significantly decreased in Period II, during which this intervention was not performed (between 7 and 12 months after the start of measurements). Based on these results, lifestyle improvements were effective in Period I regardless of sex or age; however, it may be important to maintain an improved diet and subject motivation in the future. The results of this study suggest that community pharmacists play an important role in community medicine through positive intervention for local residents' health support.

A model of health education and management for osteoporosis prevention

Osteoporosis, a chronic disease with no therapeutic cure, affects a growing number of people as the aging population in China rapidly increases. Therefore, developing an evidence-based model of health education and management for osteoporosis prevention is required. In the present study, an osteoporosis club was established, which is a novel model of health education and management for osteoporosis prevention. A unified management of membership was used based on a digitized database. A total of 436 patients with osteoporosis were randomly assigned to the osteoporosis club group or the self-management control group. For the osteoporosis club group, multiple activities of health education were performed, including monthly systematic health education lectures, exercise programs and communication parties once a year. For the control group, the participants took charge of their own musculoskeletal health. All data of the participants were collected and evaluated prior to and following intervention. In the pre-intervention assessment, no significant difference was identified in the health education between the two groups. Through the four-year intervention, the osteoporosis knowledge, health beliefs, living behavior, medication compliance, quality of life and bone mineral density of the osteoporosis club group were improved significantly compared with the control group (P<0.001), while the pain degree of the osteoporosis club group was relieved significantly more compared with the control group (P<0.001). The results in the present study suggest that setting up an osteoporosis club is an evidence-based model of health education and management for osteoporosis prevention in China.

Reliability and validity of the Chinese versions of self-efficacy and outcome expectations for osteoporosis medication adherence scales in Chinese immigrants

BACKGROUND AND PURPOSE

To assess the psychometric properties of Chinese versions self-efficacy and outcome expectations on osteoporosis medication adherence (SEOMA-C and OEOMA-C) scales.

METHODS

Back-translated tools were assessed by internal consistency and R2 by structured equation modeling, confirmatory factor analyses, hypothesis testing, and criterion-related validity among 110 (81 females, 29 males) Mandarin-speaking immigrants (mean age = 63.44, SD = 9.63).

RESULTS

The Cronbach's alpha for SEOMA-C and OEOMA-C is .904 and .937, respectively. There was fair and good fit of the measurement model to the data. Previous bone mineral density (BMD) testing, calcaneus BMD, self-efficacy for exercise, and osteoporosis medication adherence were positively related to SEOMA-C scores.

CONCLUSION

These scales constitute some preliminary validity and reliability. Further refined and cultural sensitive items could be explored and added.

Lifestyle modifications to improve musculoskeletal and bone health and reduce disability--a life-course approach

This review covers the evidence relating to lifestye modification in the big three musculoskeletal conditions: osteoarthritis, osteoporosis and rheumatoid arthritis. Lifestyle is of considerable importance in the first two and there is emerging evidence for rheumatoid arthritis despite it not traditionally being considered a lifestyle disease.