Improved Bone Health Behavior Using Community Pharmacists as Educators

Abstract

Background: Osteoporosis is an exceedingly common, morbid, and potentially fatal disease. Efforts to improve the prevention, diagnosis and treatment of osteoporosis in people living in Central Pennsylvania were instituted in 1996 by the Geisinger Health System. With a catchment of over 2 million people, over 600 physicians and 50 primary care sites, this physician-led system of healthcare is uniquely positioned to influence the delivery of healthcare.

Objective: To determine whether the pilot Community Pharmacist Osteoporosis Education Program, a specific project of the osteoporosis disease management program by the Geisinger Health System, improved bone health behavior.

Methods: The Community Pharmacist Osteoporosis Education Program, focused on physician and allied healthcare provider guidelines, community intervention, 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 community. Baseline, satisfaction, and follow-up questionnaires were administered. High risk participants received a follow-up telephone encounter. Primary care physicians were notified about the program and their patients’ participation.

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 were uniformly satisfied with the course content and class delivery: 74% rated 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 counsel 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 program that provides a standard and consistent educational approach, physician communication, and a reminder system led to better bone health behavior in women in the community.