Abstract

Summary

     In this systematic review, the effects of osteoporosis patient education were examined. All studies found an effect on physical function, but for the other themes, the results were inconclusive. The findings indicate a need for further research in this topic.

Introduction

     Osteoporosis is a chronic disease with serious consequences for the individual and major societal costs. With the aim of fracture prevention, many countries offer osteoporosis patient education. The objectives were to examine the effects and mediators of osteoporosis patient education and describe the characteristics of studies with and without an effect. Though, none of the included studies reported mediators, and therefore, we could not examine that.

Methods

     Six databases were searched in October 2020. Two researchers independently conducted title and abstract screening as well as full-text review. Records were included if participants had osteoporosis, and the patient education was group-based, face-to-face, and addressed two or more aspects, e.g., diet, medication, and exercise. The Cochrane Collaboration tools were used for risk of bias assessment. Finally, data were extracted into a standardized form and presented narratively.

Results

     In total, 2934 records were identified, and 13 studies met the inclusion criteria. All six studies examining the effects of patient education on physical function demonstrated improvements. In addition, one out of two RCT studies and one non-randomized study reported improved psychological wellbeing. Just one out of five RCT studies showed improvements regarding physical discomfort and disability. Effects on health-related quality of life, adherence and persistence, and knowledge of osteoporosis were inconclusive.

Conclusion

     There is limited evidence for the effectiveness of osteoporosis patient education. There is a need for high-quality randomized controlled trials, which should describe the characteristics of the interventions and examine the mechanisms of osteoporosis patient education.

Introduction

     Osteoporosis is a chronic disease that causes reduced density and quality of the bones and thereby increases the risk of fractures. It is estimated that 27.6 million people in Europe have osteoporosis [1]. The disease and the related fractures have high societal costs (€۳۷٫۴ billion in Europe) [1] as well as individual consequences, such as decrease in quality of life [2], change in self-image, and dependency on others [3].

      Osteoporosis is normally treated by ensuring sufcient levels of calcium and vitamin D in the diet, preventing immobilization by staying physically active, and initiating pharmacological treatment [4, 5]. Therefore, patients with osteoporosis may beneft from patient education covering these themes. The aim of osteoporosis patient education is to increase participants’ understanding, skills, and confdence [4] as well as medication compliance and persistence [4, 6], and thereby prevent fractures. During osteoporosis patient education, the participants should get training and information, but patient education should not just provide information, it should also enable behavioral change if participants * M. Rubæk merub@sdu.dk 1 National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark 2 National Research Center for Bone Health, Zealand University Hospital, Køge, Denmark / Published online: 12 November 2021 Osteoporosis International (2022) 33:959–۹۷۷ ۱ ۳ have the opportunity to interact with health professionals and gain social and psychological support from a group of participants [4, 6].

Conclusions

     Previous studies have indicated that osteoporosis patients may beneft from patient education. However, research on this topic is sparce and inconsistent. In this systematic review, we found that patient education has an efect on physical function. For the other themes, the results were inclusive and for mediators, there were no data.

     As there are some shortcomings in the included studies, there is potential for further research on this topic. There is a need for studies that evaluate osteoporosis patient education in well-conducted randomized controlled trials with long follow-up periods. It is crucial that they describe the characteristics of the studies so that they can be compared and implemented in practice. Moreover, they should examine the mediators and thereby contribute to a wider understanding of the mechanisms of osteoporosis patient education.