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Overview Page 3
Abstract
The following abstract
was presented at the ACOG 51st Annual
Clinical Meeting, April 26-30, 2003,
New Orleans, Louisiana.
Osteoporosis counseling study: a randomized clinical trial
Mark A. Binstock, MD, MPH
Margaret F. Griffin, MSN, CNP
OBJECTIVE
Compliance with osteoporosis medications
is low, similar to therapy for other chronic
disorders. The purpose was to investigate
the impact of an intensive counseling session
by a specially trained nurse on therapy
compliance, satisfaction, and therapy costs
among patients undergoing bone density
testing (DXA).
METHODS
74 post-DXA patients who met treatment
thresholds (National Osteoporosis Foundation
and/or high risk for hip fracture) were
offered participation. They were randomized
3:1 between the intensive counseling (IC)
(57 patients) and usual care (UC) (17
patients). Patients in both groups received
individualized reports summarizing their
results and treatment recommendations
along with a 24-page pamphlet. Usual Care
patients were instructed to contact their
ordering provider to review results and discuss
therapy. Intensively Counseled patients
received concurrent counseling by a nurse
including: indications, therapy advised,
risks and/or side effects, costs, enrollment
in manufacturer's drug assistance program
as needed, and issuance of a prescription. All
patients were surveyed at 1 month. Pharmacy
costs and patient drug co-payments
were assessed.
RESULTS
IC patients had higher rates of bone protective
drug use (79% versus 65%), satisfaction
with care experience (8.4% versus 8.1%),
and drug assistance program enrollment
(54% versus 0%), and lower out-of-pocket
drug costs per patient ($64 versus $73)
and health plan drug acquisition costs per
patient ($191 versus $215) than UC patients.
CONCLUSION
Structured counseling after DXA by a specially
trained nurse leads to improved
medication compliance and patient satisfaction
while reducing drug copayments
and health plan acquisition costs.
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