Improved bone health behavior using community pharmacists as educators - The Geisinger Health System Community Pharmacist Osteoporosis Education Program

Background: Osteoporosis is an exceedingly common, morbid, and potentially fatal disease. Efforts to improve the prevention, diagnosis and treatment o f osteoporosis in people living in Central Pennsylvania were instituted in 1996 by the Geisinger Health System. With a catchment of over 2 million peo ple, over 600 physicians and 50 primary care sites, this physician-led syst em of healthcare is uniquely positioned to influence the delivery of health care. Objective: To determine whether the pilot Community Pharmacist Osteoporosis Education Program, a specific project of the osteoporosis disease manageme nt program by the Geisinger Health System, improved bone health behavior. Methods: The Community Pharmacist Osteoporosis Education Program, focused o n physician and allied healthcare provider guidelines, community interventi on, bone density testing, and outcomes analysis, can improve bone health. A group of highly motivated community-based pharmacists were educated about menopause and osteoporosis prevention, diagnosis, and treatment. They were provided with a uniform educational program and held classes in the communi ty. Baseline, satisfaction, and follow-up questionnaires were administered. High risk participants received a follow-up telephone encounter. Primary c are physicians were notified about the program and their patients' particip ation. Results: Approximately 350 women attended the classes. The mean age was 54 years, 99.4% were Caucasian, and 47% had some education beyond high school. One-third had a family history of osteoporosis or fracture. Participants w ere uniformly satisfied with the course content and class delivery: 74% rat ed the class as excellent'. 26% as 'good'. Follow-up questionnaires at 4 to 6 months demonstrated that of those who were not previously doing so, 58% began taking calcium supplements, 32% exercised more, 50% sought the counse l of their primary care physician, 29% obtained a test of bone density, and 33% started a prescription medication for osteoporosis therapy as a result of attending the class. High risk participants were more likely to obtain a test of bone density after the program than were low risk participants. Conclusion: This program demonstrates that community-based pharmacists can serve as a valuable member of the healthcare provider team. An organized pr ogram that provides a standard and consistent educational approach, physici an communication, and a reminder system led to better bone health behavior in women in the community.