title: The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population-based randomized controlled trial.
abstract: This study assessed whether osteoporosis diagnosis and treatment after an osteoporotic fracture can be increased by providing osteoporosis reading material to patients and family doctors or by watching a videocassette about osteoporosis. Educating patients about osteoporosis had little impact on whether a woman received an osteoporosis diagnosis or treatment.
  
  
  BACKGROUND
  The purpose of this study was to investigate the impact of two education-based interventions on osteoporosis diagnosis and treatment in women ≥ 50 years of age after fragility fracture.
  
  
  METHODS
  Six to eight months after fracture, women were randomized into three groups: (1) control, (2) written materials, or (3) videocassette and written materials. Written materials for both the patient and physician detailed osteoporosis, fragility fracture, and available treatments; written materials for physicians were provided through patients. The educational videocassette presented similar information as the written material, but in greater depth. Rates of osteoporosis diagnosis and treatment following intervention were compared among groups using survival analysis methods. Statistical significance was set at p < 0.0167.
  
  
  RESULTS
  At randomization, 1,174 women were without osteoporosis diagnosis and treatment, and after follow-up, 12% of the control group, 15% of the written materials group (p = 0.073), and 16% (p = 0.036) of the videocassette and written materials group were diagnosed with osteoporosis (statistical comparisons to control). Treatment rates were 8% for the control group, 12% for the written materials group (p = 0.052), and 11% for the videocassette and written materials group (p = 0.157). At randomization, 1,314 women were without treatment and after follow-up therapy was initiated in 10% of the control group, 13% of the written materials group (p = 0.107), and 13% of the videocassette and written materials group (p = 0.238).
  
  
  CONCLUSIONS
  The educational interventions assessed in this trial were not satisfactory to increase osteoporosis diagnosis or treatment in recently fractured women to a clinically meaningful degree.
authors.affiliation: Department of Medicine, CHUL Research Centre, Laval University, Quebec City, PQ, Canada. louis.bessette@crchul.ulaval.ca
authors.forename: L
authors.initials: L
authors.lastname: Bessette
authors.forename: K S
authors.initials: KS
authors.lastname: Davison
authors.forename: S
authors.initials: S
authors.lastname: Jean
authors.forename: S
authors.initials: S
authors.lastname: Roy
authors.forename: L G
authors.initials: LG
authors.lastname: Ste-Marie
authors.forename: J P
authors.initials: JP
authors.lastname: Brown
mesh_terms: D000368:Aged; D003695:Delivery of Health Care / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000209:etiology; D010353:Patient Education as Topic; D010821:Physicians, Family / Q000193:education*; D015397:Program Evaluation; D011642:Publications; D014743:Videotape Recording