COMPARATIVE EFFECTIVENESS OF VARIOUS EDUCATIONAL PROGRAMS IN OSTEOPOROSIS

Background: educational programs may be beneficial in a variety of important factors for the prevention, treatment and management of osteoporosis. Objectives: to evaluate the influence of the three different educational interventions on knowledge, dietary calcium, physical activities and adherence to treatment of osteoporosis. Methods: 117 patients (middle age 63.3 ± 8.1 years old, 95.7% are women) with osteoporosis have been included in this study. All patients were randomized to three groups. The patients of intervention group (n=39) had an osteoporosis school program (4 lessons with using interactive methods in groups of 5-8 patients). The patients of the control group (n=38) received brochures with general information about osteoporosis. The patients of the comparison group(n=40) received lecture (1 x 1.5 h) about osteoporosis. Average changes from baseline in knowledge, dietary calcium, physical activities and time of physical exercises was evaluated in 3, 6 and 12 months. Adherence to treatment was evaluated in 12 months. Results: After educational programs level of knowledge was increased in patients of the intervention group in 3, 6 and 12 months by 23,8%, 22,9%, 21,1%, in the group of brochures - by 0.5%, 1.8%, 4.7%, correspondingly, p<0.01. In the group, who received lecture level of knowledge was increased by 18.0%, 15.8%, 14.6% (р<0.05 when compared with the brochure at visits 3 and 6 months). The using of dietary calcium was increased in 3, 6 and 12 months in the intervention group by 188.5 mg, 211.8 mg and 238.1 mg. In group,whoreceivedbrochuresby 146.8 mg, 106.4 mg, 84.4 mg, in group,whoreceived lecture by 66.0 mg, 80.4 mg and 68.3 mg (p<0.05when compared intervention group with the group,who received lecture at visits 3 months).Physical activity was increased in 3, 6 and 12 months in intervention group by 1.7, 1.9, 0.9 scores and was significantly higher, than in group,whoreceived lecture(0.2, 0.2, 0.1 scores) and in control group,whoreceived brochures(0.1, 0.2, 0 scores). Time of physical exercises was increased by 45.1, 54.2 и 49.9 min in week in the intervention group and was significantly more than in the groups,whoreceived lecture or brochures. Adherence to pathogenetic osteoporosis treatment was higher in the intervention group: 56.4% of intervention group, and 30.0% of the group,whoreceived lecture, and 13.2% of group,whoreceived brochures took pathogenetic medication regularly during the year (p<0.01when compared the intervention group with the control group). Conclusions: educational program with using interactive methods in small groups increases knowledge about of osteoporosis, dietary calcium,physicalactivities and increases adherence to treatment of pathogenetic medication more than brochure and lecture.