Diet and exercise changes following bone densitometry in the Patient Activation After DXA Result Notification (PAADRN) study

Roblin, Douglas W.; Cram, Peter; Lou, Yiyue; Edmonds, Stephanie W.; Hall, Sylvie F.; Jones, Michael P.; Wright, Nicole C.; Wolinsky, Fredric D.

doi:10.1007/s11657-017-0402-8

Cited by 3 publications

(4 citation statements)

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“…A majority of these studies included patients with osteoporosis or who were at high risk of fracture (i.e., patients referred for a DXA scan and osteoporosis screening, postmenopausal women, and patients who had already suffered from a fragility fracture [ n = 13]). Other studies evaluated populations of premenopausal women ( n = 1) [ 70 ], participants 50 years of age and older without any other specificities ( n = 3) [ 64 , 68 , 69 ], men receiving androgen deprivation ( n = 1) [ 76 ], and a healthcare physician ( n = 1) [ 79 ].…”

Section: Resultsmentioning

confidence: 99%

“…The most investigated tool for communicating risk of fracture consisted of a letter noting the patient’s risk of fracture and an educational brochure mailed quickly after the DXA scan [ 58 , 64 , 66 , 68 – 70 , 75 , 76 ]. This is considered to be a rapid, low-cost, direct-to-patient tool for communicating risk of fracture.…”

Section: Resultsmentioning

confidence: 99%

“…In four RCTs [ 64 , 66 , 68 , 69 ], researchers sent an educational brochure and a letter with an individual’s risk of fracture (the letters presented results of the DXA, the diagnosis of osteoporosis, osteopenia or normal, as well as a graph of the 10-year probability of suffering a major osteoporotic fracture) to patients and they evaluated the impact of this risk fracture communication tool on different outcomes (e.g., calcium and vitamin D intake, better knowledge of osteoporosis, enhancing preventive measures against risk of fractures). Results highlighted modest benefits for this type of communication with regard to osteoporosis knowledge, self-efficacy, and lifestyle behaviors (diet and exercise) in comparison with usual care.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 19 studies were included in this part: 12 randomized controlled trials [57,[64][65][66][67][68][69][70][71][72][73][74], three pre-post intervention studies [58,75,76], three qualitative studies using interviews [60,77,78], and one observational study [79]. A majority of these studies included patients with osteoporosis or who were at high risk of fracture (i.e., patients referred for a DXA scan and osteoporosis screening, postmenopausal women, and patients who had already suffered from a fragility fracture [n = 13]).…”

Section: Summary Of Research About Specific Techniques/approaches To Communicating About Risk Of Fracturementioning

confidence: 99%

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Effective communication regarding risk of fracture for individuals at risk of fragility fracture: a scoping review

Beaudart

Hiligsmann

et al. 2021

Osteoporos Int

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Two scoping reviews were conducted to review recommendations and guidelines for communication regarding general health risk, and to investigate communication strategies regarding risk of fracture. Healthcare professionals are invited to apply these recommendations to optimize a patient-centered approach to reducing risk of fracture. Introduction To conduct a scoping review of the medical literature regarding recommendations and tools for effective communication between healthcare professionals and patients regarding general health risk and risk of fracture. Methods The scoping review was divided into two parts to search for (1) studies presenting recommendations and guidelines for communication regarding general health risk; (2) studies investigating communication regarding risk of fracture for individuals at risk for fractures. Medline was searched in April 2020 to identify relevant studies. Results The scoping review included 43 studies on communication with regard to general health risk and 25 studies about communication regarding risk of fracture. Recommendations for effective communication with regard to risk are presented. Communication of numeric data on risk should be adapted to the literacy and numeracy levels of the individual patient. Patient understanding of numerical data can be enhanced with appropriate use of visual aids (e.g., pie charts, icon arrays, bar charts, pictograms). The FRAX® tool is the most recommended and most used tool for assessing risk of fracture. Communication sent as individualized letters to patients following DXA scans has been studied, although patient understanding of their risk of fracture is often reported as low using this technique. Use of visual aids may improve patient understanding. Conclusion Healthcare professionals are encouraged to apply recommendations presented in this scoping review in their clinical practice. Patient understanding of risk of fracture should be confirmed by making sure that patients feel free to ask questions and express their concerns. This will contribute to an optimal patient-centered approach. Developing online tools to convert the probability of fracture into patient-friendly visual presentations could facilitate communication between healthcare professionals and patients about risk of fracture.

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