Intensive and prolonged health promotion strategy may increase awareness of osteoporosis among postmenopausal women

The aim of the study was to measure the results of a 15-year health promoti on strategy towards osteoporosis, in an urban community of subjects over 45 years old, in terms of osteoporosis awareness and handling. To this end an ancillary study to a large survey of the Belgian population's self-perceiv ed health status was carried out. A rectangular sample of 4800 individuals over 45 years old was randomly selected in two Belgian cities, among the af filiates of the two main health insurance providers. One of the cities (Lie ge) had been, since the early 1980s, the target of a constant health promot ion strategy, directed to both the medical community and the general popula tion, aimed at increasing osteoporosis awareness in women after the menopau se, During the same period, no particular steps were taken in the other cit y (Aalst) to increase osteoporosis awareness in the community. In our study , the participants were asked to spontaneously report any chronic, serious and/or severe disorders that they had been suffering from, for at least 6 m onths, during the previous 12 months. They also provided a list of drugs th ey were taking at the time of the survey. Osteoporosis was reported to be a disease affecting 1.5% of men in Aalst and 1.3% of men in Liege (p = 0.61) . For women, osteoporosis was reported to be present in 4.8% in Aalst and 1 0.8% in Liege (p<0.001). Self-reporting of osteoporosis prevalence in Liege was statistically significantly higher in women aged 45-64 years, 65-74 ye ars or over 75 years (p<0.001). Obesity, alcohol consumption or physical ac tivity were equally distributed between women from Liege and Aalst. Prescri ption drugs used for osteoporosis had been delivered to a similar proportio n of men in Aalst and Liege. In women, a statistically significant differen ce in these prescription drugs was observed between Liege and Aalst, both f or the overall population (p<0.001) and in each of the age classes (p<0.001 for 45-64 years and 65-74 years; p<0.009 for over 75 years). A continuous long-term health promotion strategy, directed toward both physicians and th e general population, thus appears to increase awareness about osteoporosis in women over 45 years and/or in the medical community. This is reflected by an increase in self-reported prevalence of osteoporosis and in the presc ription of drugs aimed at prevention and treatment of this disorder. Whethe r these observations reflect an appropriate diagnosis and a proper handling of the disease remains to be evaluated by objective diagnostic tools such as bone densitometry and by an evaluation of the effectiveness of prescript ion practices in postmenopausal women.