Unique co-operative worksite-based osteoporosis project - Employer, healthcare plan and pharmaceutical company combine efforts to screen and manage women at risk

Background: Osteoporosis is considered a disease that affects elderly women . Younger, working-aged women are seldom considered to be at risk, although low bone mass may occur at menopause or even earlier. Bone density testing for working women may therefore be considered of low priority for both wom en and their employers, especially if they perceive that there is a low ris k of having low bone density at this age. We have designed a project to tes t bone density of women at their worksites. Objective: To: (i) create a method to detect silent bone loss in an employe d population of women at their worksite; (ii) create a service to provide e ducation and assist in compliance with management of low bone density for t hose affected; (iii) measure the effectiveness of these interventions. Study design and methods: This study is a collaboration of an employer, the managed care organization, which provides healthcare coverage for this emp loyer, and a pharmaceutical company which has long been involved in bone de nsity research. We performed bone density screening of working women at the ir worksites who, based on a risk assessment, were potentially at risk of o steopenia or osteoporosis. Forearm bone density was assessed for each woman . For those women found to have low bone mass, a series of interventions, i ncluding worksite counseling and periodic telephonic follow-up, was provide d to help them understand more fully their screening results and the need f or interventions, including lifestyle changes, and follow-up with their pri mary care physicians for diagnosis and treatment. Data were collected befor e and after the interventions for each woman to measure outcomes, complianc e and satisfaction with the screenings and interventions. Participants: 52 women employed by Sara Lee Corporation who participated in the healthcare trial and were found to have low bone density. All agreed t o participate in the year-long interventions. Results: We found that these women reported increased knowledge about low b one density, compliance with their medications, and lifestyle habits follow ing screening, counseling and periodic telephonic follow-up. In addition, a s a result of the screenings performed, a significant proportion of these w omen (with low bone mass) were confirmed to have osteopenia or osteoporosis by their physicians, and started on therapy. Satisfaction with the screeni ng process and telephonic management was uniformly high, with >95% of the w omen rating the services of the project as 'good' or 'excellent'. Conclusion: A worksite-based bone density testing method such as this was w ell received by those who participated. It led to improved detection and tr eatment of a group of younger, working-aged women who may have otherwise no t undergone such testing until a much later age, if at all. This earlier de tection and treatment may prevent further loss of bone mass and likelihood of clinical fracture. The collaboration between an employer, a managed care organization, and a pharmaceutical company enhanced the design and deliver y of a functional project for a worksite-based bone density screening and c ontributed largely to its success.