Non-pharmacological management of community dwelling individuals with osteoporosis or at risk of developing osteoporosis
Abstract
Background:
Osteoporosis is a bone disease that increases the risk of fractures. In adults aged 50-65 years, a wrist fracture is usually the first sign of osteoporosis. Fracture risk increases if these individuals are not taught to exercise, eat properly, and/or identify fall risk factors early in their diagnosis.
Methods:
A meta-analysis was conducted to determine whether a home fall hazard identification program could reduce the risk of falls in community dwelling adults and an overview of exercise in individuals with a distal radius fracture (DRF). CINHAL, PubMed, EMBASE, Scopus, and Psych INFO were used to identify articles. A survey was distributed to individuals with osteoporosis to ask them their exercise preferences. In-depth interviews were conducted to better understand the type of health professionals providing osteoporosis management advice. Interviews were transcribed verbatim and coded sentence-by-sentence. A randomized control trial was developed as a feasibility study. Participants engaged in the home program online, twice a week for six weeks. Trial registration: NCT03997682
Results:
In the falls meta-analysis, a total of 8 studies (n=8) and 5,177 participants were included. Pooled effects from 5 studies indicated no difference between fall hazards identification programs and control. Exercise improves health outcomes following DRF, but study quality was poor. Survey data from 287 individuals was collected. The sample was 90% female with a mean age of 67 (SD: 10.7) years. Home (n=171, 62%) was the preferred location to exercise. Improving strength (n=241, 84%) was the most important goal and reducing falls (n=129, 45%) was the least important. In the interviews, it was found that people with osteoporosis rely on physicians, other healthcare professionals, and non-healthcare professionals for advice. In the RCT, 63 participants were recruited over 12 months. The threshold for demonstrating retention was met (75% of participants attending their 6-month visit). Adherence was not met, at 56%.
Discussion:
We used patient input and the literature to ensure the intervention for the RCT is evidence based. Preliminary results indicate that the RCT is feasible, by approaching our recruitment numbers and retention goals, should we decide to move forward with a full RCT.