In an effect evaluation the investigators will examine the effects of participating in osteoporosis patient education. An intervention group who have already participated in patient education will be compared to a matched control group who have not participated. Effects on quality of life, fractures, daily functional capacity, self-efficacy, psychological wellbeing, physical function, balance, falls, pain management, and adherence will be examined.
In this quasi-experimental study the investigators will conduct an effect evaluation that compares an intervention group of osteoporosis patients who have participated in patient education in a municipality with a control group who have not participated. The intervention group consists of citizens who have already participated in osteoporosis patient education from 2016 until 2020. The investigators have received information on the intervention group from the municipalities who store data on previous participants. The control group will be extracted via the Danish Health Data Authority and consists of citizens who have not participated in osteoporosis patient education. For each individual in the intervention group one control will be matched regarding gender, age, diagnosis, time of diagnose, and type of fracture before the index date (i.e. the date the individual in the intervention group started on patient education). The aim of the effect evaluation is to examine the effects of osteoporosis patient education on quality of life, fractures, daily functional capacity, self-efficacy, psychological wellbeing, physical function, balance, falls, pain management, and adherence. Data is generated from a register extraction and a questionnaire-based survey. The questionnaire will include information on quality of life, daily functional capacity, self-efficacy, psychological wellbeing, physical function, balance, falls, and pain management. As far as possible validated questionnaires will be included to measure these outcomes. The register extraction will be made by the Danish Health Data Authority and include information on fractures and adherence. All analyses are performed using Stata. In the analyses the investigators will compare the intervention group and the control group with regard to all outcomes. The covariates are selected on the basis of Directed Acyclic Graphs (DAG) and they include e.g. socioeconomic status, cohabitee status, and co-morbidity. The analysis will be completed on an intention to treat basis.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
3,132
During osteoporosis patient education the participants get knowledge about e.g. osteoporosis, medication, and diet, and they participate in physical exercises. Though, differences between municipalities exist. The participants meet in groups and face-to-face.
National Institute of Public Health, University of Southern Denmark
Copenhagen, Denmark
Differences in quality of life between intervention and control group
Measured with the 12-item Short-Form Health Survey of the Medical Outcomes Study (SF-12)
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)
Differences in clinical diagnosis of fracture between intervention and control group
Including hip, vertebral, forearm, and upper arm fractures registered in the National Patient Register
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)
Differences in daily functional capacity between intervention and control group
Measured with questions from the European Health Interview Survey
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)
Differences in self-efficacy between intervention and control group
Measured with the questionnaire Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G)
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)
Differences in psychological well-being between intervention and control group
Measured with the questionnaire Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS)
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)
Differences in physical function between intervention and control group
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Measured with questions from The Danish National Health Survey
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)
Differences in balance between intervention and control group
Measured with self-constructed, validated questions regarding problems with balance and balance confidence
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)
Differences in falls between intervention and control group
Measured with self-constructed, validated questions regarding number of falls and concerns about falling
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)
Differences in pain management between intervention and control group
Measured with the Pain Self-Efficacy Questionnaire (PSEQ)
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)
Differences in adherence by Medication Possession Ratio (MPR) between intervention and control group
Including adherence to alendronate and ibandronate attained from the Danish National Prescription Registry
Time frame: At follow-up (1 to 6 years after the index date i.e. the date the individual in the intervention group started on patient education)