Authors (including presenting author) :
Wong WP(1), Cheng MW(1), Koo WK(1), Wong YS(1), Liu BKP(2), ,Au Yeung YT(1),
Chao CYL(2), Chan ACM(2)
Affiliation :
(1)Medicine, Queen Elizabeth Hospital
(2)Physiotherapy Department, Queen Elizabeth Hospital
Introduction :
Fragility fracture may lead to patient’s physical decline, psychological distress, social isolation and increase mortality. Compliance in taking osteoporotic medications, calcium and vitamin D supplements, exercise and prevention of fall are crucial to prevent fracture. Studies showed that osteoporotic patient education is indispensable to enhance patient’s self-efficacy. A 12-month Patient Education Program that run by Endocrinologist, Endocrine Nurse and Physiotherapist was designed and implemented in Queen Elizabeth Hospital (QEH).
Objectives :
To evaluate its effectiveness and explore rooms for improvement.
Methodology :
All Chinese patients with osteoporosis followed up at QEH between 1 April 2018 and 31 August 2019 were recruited. At visit 1, they were triaged into high fall risk group (HFRG) or low fall risk group (LFRG) according to the Berg-Balance-Scale and Timed-up-and-go-Test. A 1.5-hour osteoporosis group education would provide knowledge about the disease including medications, diet and exercise. Two questionnaires, Osteoporosis Self Efficacy Scale-Chinese (OSES-C) measuring patients’ self-efficacy and Osteoporosis Health Habit Summary (OHS) measuring osteoporosis health habit were administered by the designated nurse before and after the program. Further assessment and lifestyles reinforcement would be done during visit 2 and 3. Data were analyzed with descriptive statistics, paired samples t-test, independent-samples t-test and ANOVA.
Result & Outcome :
A total of 134 patients were recruited. Due to social event and pandemic outbreak in 2019-2020 in Hong Kong, only 52 participants completed the program. 49 participants were female, mean age 68.08 (±9.50), mean BMI 21.24 (±3.98), 74% in the LFRG. The pre- and post-mean score of OSES-C and OHS showed improvement in the engagement of ‘Weight Bearing Exercise’ and ‘High Calcium Diet” especially in the HFRG as compared with the LFRG (p=0.08 & p=0.017). The adherence to anti-osteoporosis medication maintained at good level 4.75/5 throughout the program though it is known to be poor usually.
Conclusion and Discussion:
This education program was able to support participants to maintain good compliance to anti-osteoporotic medications, high calcium and vitamin D absorption and weight bearing exercise especially in the HFRG. In view of the huge population of patients with osteoporosis, it might be more cost effective to recruit only those from the HFRG or with initial low self-efficacy score. However, the sample size for this program was small. Therefore, a program with longer duration and with larger sample size could be considered for this chronic disease so as to see its effects.
