Does patient partnership in continuing medical education (CME) improve the outcome in osteoporosis management?

Abstract

Introduction: There is an apparent gap between physicians' knowledge and their practical application of such knowledge. Educating patients to educate physicians toward improved care has been shown to be effective in selected settings. This study describes the influence of an active community education program on changing physician behavior.

Methods: A total of 672 schoolteachers were interviewed and screened for detection of osteoporosis risk factors. The teachers were educated about osteoporosis and the significance of bone mass densitometry (BMD) in its management and returned to their physicians with the results of their screening. One group of their physicians received didactic lectures on the results of the screening and the impact of appropriate management on the outcome of osteoporosis. The second group of physicians did not. Six months after the initial interview and screening, patients received a mailed survey.

Results: After 6 months, 258 of the teachers who had visited their physicians were resurveyed. The percentage of BMD tests ordered by physicians rose from 8.6% to 33% in both the intervention and control physician groups. Findings at the 6-month survey indicated that physicians initiated the osteoporosis discussion an average of 18% of the visits and patients did an average of 60%, prompting the physician to order a BMD test.

Discussion: In this study, there was no evidence that didactic lectures affect physician behavior in ordering BMD. There were, however, compelling indications that patient education, which included written screening results, enhanced physician-patient dialogue, resulting in more BMD orders.