What is the impact of osteoporosis education and bone mineral density testing for postmenopausal women in a managed care setting

Objective: To assess whether osteoporosis education, with and without bone mineral density (BMD) testing, increases the initiation of lifestyle change s and pharmaceutical treatment to prevent osteoporosis. Design: A total of 508 women, aged 54-65, from a large managed care organiz ation who were not on osteoporosis prevention therapy participated in an in tervention study. Participants were randomly assigned to either an educatio n class on osteoporosis (n = 301) or education plus BMD (n = 207). A contro l group of 187 women receiving no intervention were also surveyed to serve as comparison. Group differences and differences based on BMD test result w ere compared 6 months after education regarding self-reported changes in he alth behaviors using chi (2) tests and logistic regression analyses. Results: Of the 508 intervention participants, 455 (90%) responded to the f ollow-up survey. Initiation of hormone replacement therapy was reported by 9%, with 5% reporting starting alendronate. More than half reported changes in diet, exercise, or calcium intake. Forty-three percent increased their vitamin D intake. There were no significant group differences in behavior e xcept with regard to pharmaceutical therapy; subjects with education plus B MD were three times more likely than those receiving education only to repo rt starting hormone replacement therapy (p = 0.004). Low BMD scores were as sociated with increasing vitamin D intake (p = 0.03) and starting medicatio n (p = 0.001). Women in the intervention groups were significantly more lik ely to report modifying their diet (p < 0.001), calcium (p < 0.01), and vit amin D intake (p < 0.0001) than women in the control group, not exposed to education. Conclusion: Education regarding osteoporosis prevention seems to encourage women to make lifestyle changes. The inclusion of BMD testing enhances the likelihood that women will consider pharmaceutical therapy.