Osteoporosis is a disease characterized by a decrease in bone mineral density (BMD), leading to increased susceptibility to fractures. It affects both sexes and all racial groups and is estimated to be responsible for 9 million fragility fractures annually worldwide.1 About one in every two Caucasian women will experience an osteoporotic fracture at some point in their lifetime, as will approximately one in five men.2 Diagnosis of BMD disorder is made through the use of Dual Emission X-ray Absorptiometry (DEXA) scanning. This was done to determine whether they had osteoporosis, osteopenia, or normal BMD. DEXA measures bone density at common sites of fracture, such as the hip and spine, and it represents the gold standard for diagnosing osteoporosis or osteopenia. Patients are given a score which represents the standard deviation of their bone-density compared to either that of a healthy 30-year-old (T-score) or that of an aged-matched individual (Z-score) if the patient is under 50 years of age (or has undergone a hysterectomy).

Patient morbidity and mortality increases significantly after a fracture, particularly hip fractures where reports indicate a 10 to 20 percent excess mortality within one year of the fracture.2 Given the significant prevalence and enormous burden to the individual and society, it is important that patients with osteoporosis, osteopenia, or normal BMD with risk factors for decreased bone mineral density (e.g. medication side-effects, poor nutritional intake etc.) have the proper knowledge to manage their condition. This empowers them to make positive lifestyle choices to help prevent fractures and future complications. Indeed, it has been found that osteoporosis patients that are more educated on their disease, have better physical functioning and psychological well-being.3,4 Furthermore, a patient that is well-informed of their disease is needed in the shared decision making approach model, which has been shown to aid in osteoporosis management.5, 6, 7 As patients seek a more active role in the decision making process of their care, educating them on their disease is more necessary than ever.8

Published studies have revealed that many patients diagnosed with osteoporosis or osteopenia lack a proper understanding of their condition.9 Grover et al. demonstrated that patients with intermediate and severe forms of osteoporosis have the greatest discrepancy in understanding their fracture risk.10 Such patients tend to perceive their condition as being less severe than it actually is, and this is of primary concern to physicians because it poses a serious risk to the health of their patients. Furthermore, related studies have demonstrated the significant role of proper patient education in the prevention of osteoporosis along with the significance of having patients with some diagnostic understanding.11,12 This lends support to the importance of improving patient knowledge about the options available for treatment, adherence expectations, and the value of lifestyle modifications to minimize risk factors associated with bone loss.

Recently, research has focused on determining the effectiveness and accuracy of medical information presented to patients. The findings reported by a patient questionnaire study conducted by Sale et al. demonstrated how information provided by different healthcare providers can be inconsistent.13 Relevant to this discussion is the variable effectiveness of different modalities in patient education, as well as personal preferences patients may have with regard to learning delivery. While physicians and researchers alike have recognized the crucial role of proper patient education, a knowledge gap remains as to which educational modalities are preferred by patients. The ultimate goal of education is to equip patients to be more health-conscious about their condition.

Given the significance of patient understanding of BMD diagnosis and screening on overall wellbeing, the relevance and accuracy of education provided is paramount. This includes, but is not limited to, information garnered through interactions with healthcare professionals and independent patient research. Using a patient survey, this study measured osteoporosis-relevant knowledge of patients that have been diagnosed with osteoporosis or osteopenia and patients with normal BMD that are being screened due to their risk factors. This study further aimed to obtain descriptive information from patients regarding the most common sources they use to obtain their medical information (such as brochures, seminars, and the internet) and gather data about which of these were most preferred. Physicians gain valuable insight by assessing and understanding patient preferences and perceived efficacy with respect to health education, as the right education can motivate patients to implement health-conscious decisions into their daily lives. Through this study we hope to provide the medical community with data regarding the effectiveness of the current educational approaches taken by physicians and the patients themselves, as well as to provide the foundation for refining how patients can learn.