Skip to main content
Top
Published in: Osteoporosis International 10/2010

01-10-2010 | Review

A systematic review of interventions by healthcare professionals on community-dwelling postmenopausal women with osteoporosis

Authors: P. Lai, S. S. Chua, S. P. Chan

Published in: Osteoporosis International | Issue 10/2010

Login to get access

Abstract

Summary

A systematic review was conducted to evaluate evidence concerning the effect of non-drug interventions by healthcare professionals on community-dwelling postmenopausal osteoporotic women. Evidence available indicates that such interventions are effective in improving the quality of life, medication compliance, and calcium intake, but effect on other outcomes is less conclusive.

Introduction

The purpose of this study is to conduct a systematic review to evaluate evidence concerning the effect of non-drug interventions by healthcare professionals on community-dwelling postmenopausal osteoporotic women.

Methods

Randomized controlled trials (RCTs) published in English between year 1990 and 2009 were identified. Types of patient outcome used as assessment included quality of life (QOL), bone mineral density (BMD), medication compliance and persistence, knowledge level, and lifestyle modification.

Results

Twenty four RCTs met the inclusion criteria. Seven studies assessed interventions by physiotherapists, six by physicians, seven by nurses, three by multi-disciplinary teams and one by dietitians. Variability in the types and intensity of interventions made comparison between each study difficult. Collectively, these studies provided some evidence to show that interventions by healthcare professionals improved the QOL medication compliance and calcium intake of patients but its effects on BMD, medication persistence, knowledge, and other lifestyle modifications were less conclusive.

Conclusions

From this review, it was found that some outcome measures of such non-drug interventions still required further studies. Future studies should use validated instruments to assess the outcomes, with focus on common definitions of interventions and outcome measures, more intensive one-to-one interventions, appropriate control groups, adequate randomization procedures, and also provide information on effect size.
Literature
1.
go back to reference Cooper C, Campion G, Melton Lr (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289CrossRefPubMed Cooper C, Campion G, Melton Lr (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289CrossRefPubMed
2.
go back to reference Burge R, Dawson-Hughes B, Solomon DH et al (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22:465–475CrossRefPubMed Burge R, Dawson-Hughes B, Solomon DH et al (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22:465–475CrossRefPubMed
3.
go back to reference Meadows LM, Mrkonjic LA, O'Brien MD et al (2007) The importance of communication in secondary fragility fracture treatment and prevention. Osteoporos Int 18:159–166CrossRefPubMed Meadows LM, Mrkonjic LA, O'Brien MD et al (2007) The importance of communication in secondary fragility fracture treatment and prevention. Osteoporos Int 18:159–166CrossRefPubMed
4.
go back to reference Chang JT, Morton SM, Rubenstein LZ et al (2004) Interventions for the prevention of falls in older adults: systematic review and meta analysis of randomized controlled trials. BMJ 328:680CrossRefPubMed Chang JT, Morton SM, Rubenstein LZ et al (2004) Interventions for the prevention of falls in older adults: systematic review and meta analysis of randomized controlled trials. BMJ 328:680CrossRefPubMed
5.
go back to reference Gates S, Lamb SE, Fisher JD et al (2008) Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: a systematic review and meta-analysis. BMJ 336:130–133CrossRefPubMed Gates S, Lamb SE, Fisher JD et al (2008) Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: a systematic review and meta-analysis. BMJ 336:130–133CrossRefPubMed
9.
go back to reference Cohen J (1988) Statistical power analysis for the behavioural sciences. Lawrence Earlbaum Associates, Hillsdale Cohen J (1988) Statistical power analysis for the behavioural sciences. Lawrence Earlbaum Associates, Hillsdale
10.
go back to reference Sedlak CA, Doheny MO, Estok PJ et al (2005) Tailored interventions to enhance osteoporosis prevention in women. Orthop Nurs 24:270–276CrossRefPubMed Sedlak CA, Doheny MO, Estok PJ et al (2005) Tailored interventions to enhance osteoporosis prevention in women. Orthop Nurs 24:270–276CrossRefPubMed
11.
go back to reference Rolnick SJ, Kopher R, Jackson J et al (2001) What is the impact of osteoporosis education and bone mineral density testing for postmenopausal women in a managed care setting? Menopause 8:141–148CrossRefPubMed Rolnick SJ, Kopher R, Jackson J et al (2001) What is the impact of osteoporosis education and bone mineral density testing for postmenopausal women in a managed care setting? Menopause 8:141–148CrossRefPubMed
12.
go back to reference Clowes JA, Peel NF, Eastell R (2004) The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: a randomized controlled trial. J Clin Endocrinol Metab 89:1117–1123CrossRefPubMed Clowes JA, Peel NF, Eastell R (2004) The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: a randomized controlled trial. J Clin Endocrinol Metab 89:1117–1123CrossRefPubMed
13.
go back to reference Schousboe JT, DeBold RC, Kuno LS et al (2005) Education and phone follow-up in postmenopausal women at risk for osteoporosis—effects on calcium intake, exercise frequency, and medication use. Dis Manage Health Outcomes 13:395–404CrossRef Schousboe JT, DeBold RC, Kuno LS et al (2005) Education and phone follow-up in postmenopausal women at risk for osteoporosis—effects on calcium intake, exercise frequency, and medication use. Dis Manage Health Outcomes 13:395–404CrossRef
14.
go back to reference Binder EF, Brown M, Sinacore DR et al (2004) Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. JAMA 292:837–846CrossRefPubMed Binder EF, Brown M, Sinacore DR et al (2004) Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. JAMA 292:837–846CrossRefPubMed
15.
go back to reference Estok PJ, Sedlak CA, Doheny MO et al (2007) Structural model for osteoporosis preventing behavior in postmenopausal women. Nurs Res 56:148–158CrossRefPubMed Estok PJ, Sedlak CA, Doheny MO et al (2007) Structural model for osteoporosis preventing behavior in postmenopausal women. Nurs Res 56:148–158CrossRefPubMed
16.
go back to reference Majumdar SR, Johnson JA, McAlister FA et al (2008) Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial. CMAJ 178:569–575PubMed Majumdar SR, Johnson JA, McAlister FA et al (2008) Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial. CMAJ 178:569–575PubMed
17.
go back to reference Majumdar SR, Beaupre LA, Harley CH et al (2007) Use of a case manager to improve osteoporosis treatment after hip fracture—results of a randomized controlled trial. Arch Intern Med 167:2110–2115CrossRefPubMed Majumdar SR, Beaupre LA, Harley CH et al (2007) Use of a case manager to improve osteoporosis treatment after hip fracture—results of a randomized controlled trial. Arch Intern Med 167:2110–2115CrossRefPubMed
18.
go back to reference Carter ND, Khan KM, Petit MA et al (2001) Results of a 10-week community based strength and balance training programme to reduce fall risk factors: a randomised controlled trial in 65-75 year old women with osteoporosis. Br J Sports Med 35:348–351CrossRefPubMed Carter ND, Khan KM, Petit MA et al (2001) Results of a 10-week community based strength and balance training programme to reduce fall risk factors: a randomised controlled trial in 65-75 year old women with osteoporosis. Br J Sports Med 35:348–351CrossRefPubMed
19.
go back to reference Cranney A, Lam A, Ruhland L et al (2008) A multifaceted intervention to improve treatment of osteoporosis in postmenopausal women with wrist fractures: a cluster randomized trial. Osteoporos Int. doi:10.1007/s00198-00008-00669-00190 Cranney A, Lam A, Ruhland L et al (2008) A multifaceted intervention to improve treatment of osteoporosis in postmenopausal women with wrist fractures: a cluster randomized trial. Osteoporos Int. doi:10.​1007/​s00198-00008-00669-00190
20.
go back to reference Papaioannou A, Adachi JD, Winegard K et al (2003) Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int 14:677–682CrossRefPubMed Papaioannou A, Adachi JD, Winegard K et al (2003) Efficacy of home-based exercise for improving quality of life among elderly women with symptomatic osteoporosis-related vertebral fractures. Osteoporos Int 14:677–682CrossRefPubMed
21.
go back to reference Bravo G, Gauthier P, Roy PM et al (1996) Impact of a 12-month exercise program on the physical and psychological health of osteopenic women. J Am Geriatr Soc 44:756–762PubMed Bravo G, Gauthier P, Roy PM et al (1996) Impact of a 12-month exercise program on the physical and psychological health of osteopenic women. J Am Geriatr Soc 44:756–762PubMed
22.
go back to reference van Haastregt JCM, Diederiks JPM, van Rossum E et al (2000) Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: randomised controlled trial. BMJ 321:994–998CrossRefPubMed van Haastregt JCM, Diederiks JPM, van Rossum E et al (2000) Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: randomised controlled trial. BMJ 321:994–998CrossRefPubMed
23.
go back to reference Malmros B, Mortensen L, Jensen MB et al (1998) Positive effects of physiotherapy on chronic pain and performance in osteoporosis. Osteoporos Int 8:215–221CrossRefPubMed Malmros B, Mortensen L, Jensen MB et al (1998) Positive effects of physiotherapy on chronic pain and performance in osteoporosis. Osteoporos Int 8:215–221CrossRefPubMed
24.
go back to reference Delmas PD, Vrijens B, Eastell R et al (2007) Effect of monitoring bone turnover markers on persistence with risedronate treatment of postmenopausal osteoporosis. J Clin Endocrinol Metab 92:1296–1304CrossRefPubMed Delmas PD, Vrijens B, Eastell R et al (2007) Effect of monitoring bone turnover markers on persistence with risedronate treatment of postmenopausal osteoporosis. J Clin Endocrinol Metab 92:1296–1304CrossRefPubMed
25.
go back to reference Alp A, Kanat E, Yurtkuran M (2007) Efficacy of a self-management program for osteoporotic subjects. Am J Phy Med Rehab 86:633–640CrossRef Alp A, Kanat E, Yurtkuran M (2007) Efficacy of a self-management program for osteoporotic subjects. Am J Phy Med Rehab 86:633–640CrossRef
26.
go back to reference Nielsen D, Ryg J, Nissen N et al (2008) Multidisciplinary patient education in groups increases knowledge on osteoporosis: a randomized controlled trial. Scand J Public Health 36:346–352CrossRefPubMed Nielsen D, Ryg J, Nissen N et al (2008) Multidisciplinary patient education in groups increases knowledge on osteoporosis: a randomized controlled trial. Scand J Public Health 36:346–352CrossRefPubMed
27.
go back to reference Guilera M, Fuentes M, Grifols M et al (2006) Does an educational leaflet improve self-reported adherence to therapy in osteoporosis? The OPTIMA study. Osteoporos Int 17:664–671CrossRefPubMed Guilera M, Fuentes M, Grifols M et al (2006) Does an educational leaflet improve self-reported adherence to therapy in osteoporosis? The OPTIMA study. Osteoporos Int 17:664–671CrossRefPubMed
28.
go back to reference Preisinger E, Alacamlioglu Y, Pils K et al (1996) Exercise therapy for osteoporosis: results of a randomised controlled trial. Br J Sports Med 30:209–212CrossRefPubMed Preisinger E, Alacamlioglu Y, Pils K et al (1996) Exercise therapy for osteoporosis: results of a randomised controlled trial. Br J Sports Med 30:209–212CrossRefPubMed
29.
go back to reference Elley CR, Robertson MC, Garrett S et al (2008) Effectiveness of a falls-and-fracture nurse coordinator to reduce falls: a randomized, controlled trial of at-risk older adults. JAGS 56:1383–1389CrossRef Elley CR, Robertson MC, Garrett S et al (2008) Effectiveness of a falls-and-fracture nurse coordinator to reduce falls: a randomized, controlled trial of at-risk older adults. JAGS 56:1383–1389CrossRef
30.
go back to reference Hongo M, Itoi E, Sinaki M et al (2007) Effect of low-intensity back exercise on quality of life and back extensor strength in patients with osteoporosis: a randomized controlled trial. Osteoporos Int 18:1389–1395CrossRefPubMed Hongo M, Itoi E, Sinaki M et al (2007) Effect of low-intensity back exercise on quality of life and back extensor strength in patients with osteoporosis: a randomized controlled trial. Osteoporos Int 18:1389–1395CrossRefPubMed
31.
go back to reference Tsauo JY, Leu WS, Chen YT et al (2005) Effects on function and quality of life of postoperative home-based physical therapy for patients with hip fracture. Arch Phys Med Rehabil 86:1953–1957CrossRefPubMed Tsauo JY, Leu WS, Chen YT et al (2005) Effects on function and quality of life of postoperative home-based physical therapy for patients with hip fracture. Arch Phys Med Rehabil 86:1953–1957CrossRefPubMed
32.
go back to reference Chan KM, Qin L, Lau MC et al (2004) A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women. Arch Phys Med Rehabil 85:717–722CrossRefPubMed Chan KM, Qin L, Lau MC et al (2004) A randomized, prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women. Arch Phys Med Rehabil 85:717–722CrossRefPubMed
33.
go back to reference Hien VT, Khan NC, le Mai B et al (2009) Effect of community-based nutrition education intervention on calcium intake and bone mass in postmenopausal Vietnamese women. Public Health Nutr 12:674–679CrossRefPubMed Hien VT, Khan NC, le Mai B et al (2009) Effect of community-based nutrition education intervention on calcium intake and bone mass in postmenopausal Vietnamese women. Public Health Nutr 12:674–679CrossRefPubMed
34.
go back to reference Hien VT, Khan NC, le Mai B et al (2008) Effect of community-based nutrition education intervention on calcium intake and bone mass in postmenopausal Vietnamese women. Public Health Nutr 12:674–679CrossRefPubMed Hien VT, Khan NC, le Mai B et al (2008) Effect of community-based nutrition education intervention on calcium intake and bone mass in postmenopausal Vietnamese women. Public Health Nutr 12:674–679CrossRefPubMed
35.
go back to reference Roughead EE, Semple SJ, Vitry AI (2005) Pharmaceutical care services: a systematic review of published studies, 1990 to 2003, examining effectiveness in improving patient outcomes. Int J Pharm Prac 13:53–70CrossRef Roughead EE, Semple SJ, Vitry AI (2005) Pharmaceutical care services: a systematic review of published studies, 1990 to 2003, examining effectiveness in improving patient outcomes. Int J Pharm Prac 13:53–70CrossRef
36.
go back to reference Carter ND, Khan KM, McKay HA et al (2002) Community-based exercise program reduces risk factors for falls in 65 to 75-year-old women with osteoporosis: a randomized controlled trial. CMAJ 167:997–1004PubMed Carter ND, Khan KM, McKay HA et al (2002) Community-based exercise program reduces risk factors for falls in 65 to 75-year-old women with osteoporosis: a randomized controlled trial. CMAJ 167:997–1004PubMed
37.
go back to reference Ryg J, Nissen N, Nielsen D et al (2005) Patients' and population's knowledge of osteoporosis (article in Danish). Ugeskr Laeger 167:282–285PubMed Ryg J, Nissen N, Nielsen D et al (2005) Patients' and population's knowledge of osteoporosis (article in Danish). Ugeskr Laeger 167:282–285PubMed
38.
go back to reference Kim KK, Horan ML, Gendler P (1991) Osteoporosis knowledge tests, osteoporosis health belief scale, and osteoporosis self-efficacy scale. Grand Valley State University, Allendale Kim KK, Horan ML, Gendler P (1991) Osteoporosis knowledge tests, osteoporosis health belief scale, and osteoporosis self-efficacy scale. Grand Valley State University, Allendale
39.
go back to reference Pande KC, Takats D, Kanis J et al (2000) Development of a questionnaire (OPQ) to assess patient’s knowledge about osteoporosis. Maturitas 237:75–81CrossRef Pande KC, Takats D, Kanis J et al (2000) Development of a questionnaire (OPQ) to assess patient’s knowledge about osteoporosis. Maturitas 237:75–81CrossRef
40.
go back to reference Ailinger RL, Harper DC, Lasus HA (1998) Bone up on osteoporosis. Development of the facts on Osteoporosis Quiz. Orthop Nurs 17:66–73CrossRefPubMed Ailinger RL, Harper DC, Lasus HA (1998) Bone up on osteoporosis. Development of the facts on Osteoporosis Quiz. Orthop Nurs 17:66–73CrossRefPubMed
41.
go back to reference Nelson HD, Helfand M, Woolf SH et al (2002) Screening for postmenopausal osteoporosis: a review of the evidence for the US Preventive Services task force. Ann Intern Med 137:529–541PubMed Nelson HD, Helfand M, Woolf SH et al (2002) Screening for postmenopausal osteoporosis: a review of the evidence for the US Preventive Services task force. Ann Intern Med 137:529–541PubMed
42.
go back to reference Koval PG, Easterling L, Pettus D et al (2005) How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis? J Fam Pract 54(65):69–71 Koval PG, Easterling L, Pettus D et al (2005) How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis? J Fam Pract 54(65):69–71
43.
go back to reference Mazees R, Chestnut CHr, McClung M et al (1992) Enhanced precision with dual-energy X-ray absorptiometry. Calcif Tissue Int 51:14–17CrossRef Mazees R, Chestnut CHr, McClung M et al (1992) Enhanced precision with dual-energy X-ray absorptiometry. Calcif Tissue Int 51:14–17CrossRef
44.
go back to reference Lenchik L, Kiebzak GM, Blunt BA (2002) International Society for Clinical Densitometry Position Development Panel and Scientific Advisory Committee. What is the role of serial bone mineral density measurements in patient management? J Clin Densitom 5(Suppl):S29–S38CrossRefPubMed Lenchik L, Kiebzak GM, Blunt BA (2002) International Society for Clinical Densitometry Position Development Panel and Scientific Advisory Committee. What is the role of serial bone mineral density measurements in patient management? J Clin Densitom 5(Suppl):S29–S38CrossRefPubMed
45.
go back to reference Cummings SR, Bates D, Black DM (2002) Clinical use of bone densitometry scientific review. JAMA 288:1889–1897, Erratum in: JAMA 2002; 1288:2825CrossRefPubMed Cummings SR, Bates D, Black DM (2002) Clinical use of bone densitometry scientific review. JAMA 288:1889–1897, Erratum in: JAMA 2002; 1288:2825CrossRefPubMed
46.
go back to reference National Osteoporosis Foundation (2003) Physician's guide to prevention and treatment of osteoporosis. www.nof.org. 24 Aug 2009 National Osteoporosis Foundation (2003) Physician's guide to prevention and treatment of osteoporosis. www.​nof.​org. 24 Aug 2009
48.
go back to reference Weinstein RS, New KD, Sappington LJ (1991) Dual-energy X-ray absorptiometry versus single photon absorptiometry of the radius. J Calcif Tissue Int 49:313–316CrossRef Weinstein RS, New KD, Sappington LJ (1991) Dual-energy X-ray absorptiometry versus single photon absorptiometry of the radius. J Calcif Tissue Int 49:313–316CrossRef
49.
go back to reference Rosenthal DL, Mayo-Smith W, Hayes C et al (1989) Age and bone mass in premenopausal women. J Bone Miner Res 4:533–538CrossRefPubMed Rosenthal DL, Mayo-Smith W, Hayes C et al (1989) Age and bone mass in premenopausal women. J Bone Miner Res 4:533–538CrossRefPubMed
51.
go back to reference Davidson M (2003) Pharmacotherapeutics for osteoporosis prevention and treatment. J Midwifery Womens Health 48:39–54CrossRefPubMed Davidson M (2003) Pharmacotherapeutics for osteoporosis prevention and treatment. J Midwifery Womens Health 48:39–54CrossRefPubMed
52.
go back to reference Sheikh I, Ogden J (1998) The role of knowledge and beliefs in help seeking behaviour for cancer: a quantitative and qualitative approach. Pat Educ Counsel 35:35–42CrossRef Sheikh I, Ogden J (1998) The role of knowledge and beliefs in help seeking behaviour for cancer: a quantitative and qualitative approach. Pat Educ Counsel 35:35–42CrossRef
53.
go back to reference Gupta A, Thomas P (2002) Knowledge of stroke symptoms and risk factors among at-risk elderly patients in the UK. Int J Clin Pract 56:634–637PubMed Gupta A, Thomas P (2002) Knowledge of stroke symptoms and risk factors among at-risk elderly patients in the UK. Int J Clin Pract 56:634–637PubMed
54.
go back to reference Werner P (2003) Knowledge about symptoms of Alzheimer's disease: correlates and relationship to help-seeking behaviour. Int J Geriatr Psychiatry 18:1029–1036CrossRefPubMed Werner P (2003) Knowledge about symptoms of Alzheimer's disease: correlates and relationship to help-seeking behaviour. Int J Geriatr Psychiatry 18:1029–1036CrossRefPubMed
55.
go back to reference Nichols-English G, Provost M, Koompalum D et al (2002) Strategies for pharmacists in the implementation of diabetes mellitus management programs: new roles in primary and collaborative care. Dis Manage Health Outcomes 10:783–803CrossRef Nichols-English G, Provost M, Koompalum D et al (2002) Strategies for pharmacists in the implementation of diabetes mellitus management programs: new roles in primary and collaborative care. Dis Manage Health Outcomes 10:783–803CrossRef
Metadata
Title
A systematic review of interventions by healthcare professionals on community-dwelling postmenopausal women with osteoporosis
Authors
P. Lai
S. S. Chua
S. P. Chan
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Osteoporosis International / Issue 10/2010
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-010-1199-0

Other articles of this Issue 10/2010

Osteoporosis International 10/2010 Go to the issue