title: Bone density testing: an under-utilised and under-researched health education tool for osteoporosis prevention?
abstract: Feedback of fracture risk based on bone mineral density (BMD) is an under-explored potential osteoporosis education intervention. We performed a randomised controlled trial of either an osteoporosis information leaflet or small group education (the Osteoporosis Prevention and Self-Management Course (OPSMC)), combined with individualised fracture risk feedback in premenopausal women over two years. Women with a mean T-score at spine and hip of <0 were informed they were at higher risk of fracture in later life and those with T-score ≥ 0 were informed they were not. Women receiving feedback of high fracture risk had a greater increase in femoral neck, but not lumbar spine, BMD compared to the low risk group (1.6% p.a. vs. 0.7% p.a., p = 0.0001). Participation in the OPSMC had no greater effect on BMD than receiving the leaflet. Femoral neck BMD change was associated with starting calcium supplements (1.3% p.a., 95% CI +0.49, +2.17) and self-reported physical activity change (0.7% p.a., 95% CI +0.22, +1.22). Mother's report of increasing their children's calcium intake was associated with receiving the OPSMC (OR 2.3, 95% CI 1.4, 3.8) and feedback of high fracture risk (OR 2.0, 95% CI 1.2, 3.3). Fracture risk feedback based on BMD could potentially make an important contribution to osteoporosis prevention but confirmation of long-term benefits and cost effectiveness is needed before implementation can be recommended.
authors.affiliation: Menzies Research Institute, Private Bag 23, Hobart TAS 7001, Australia. tania.winzenberg@utas.edu.au
authors.forename: Tania
authors.initials: T
authors.lastname: Winzenberg
authors.forename: Brian
authors.initials: B
authors.lastname: Oldenburg
authors.forename: Graeme
authors.initials: G
authors.lastname: Jones
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D015519:Bone Density; D002136:Calcium, Dietary / Q000008:administration & dosage; D015444:Exercise; D005260:Female; D005272:Femur Neck; D050723:Fractures, Bone / Q000517:prevention & control; D006266:Health Education / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae; D008425:Maternal Behavior; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D010809:Physical Fitness; D017697:Premenopause; D012307:Risk Factors
chemical_list: D002136:Calcium, Dietary