Impact of the Fracture Risk Assessment on Patient and Physician Behavior in Osteoporosis Prevention

Abstract

Objective:

To evaluate the impact of a pharmacist-directed osteoporosis screening program utilizing the fracture risk assessment (FRAX) tool on patient and physician behavior.

Methods:

Postmenopausal women 45 to 65 years with Achilles T score <−1.0 not receiving bisphosphonate therapy were randomly assigned to a control or intervention group. All participants received a heel ultrasound and pharmacist education on risks of low bone mass. The intervention group received the FRAX and shared their results with their physician. Three months after screening, a telephonic questionnaire was administered to all participants.

Results:

A total of 749 patients were screened, with 87 meeting the enrollment criteria (43 control and 44 intervention). Physician behavior was not different between the groups with respect to ordering vitamin D levels, prescription medication, or dual-energy x-ray absorptiometry scan. A significant difference in vitamin D supplementation occurred between the 2 groups (P = .024). At follow-up, 72.2% of responding participants increased daily calcium intake and 76.4% started or increased physical activity.

Conclusion:

Physician behavior was not influenced by FRAX results in the intervention group; however, positive patient behavior changes occurred in both groups. Primary prevention efforts conducted through heel ultrasound screening and pharmacist consultation led women to follow-up; however, awareness still needs to be raised of the value of FRAX in osteoporosis prevention.