FRAX® counseling for bone health behavior change in women 50 years of age and older

Authors

  • Diane L. Dunniway DNP, APN, WHNP-BC (Adjunct Faculty),

    1. Department of Women, Children, & Family Health Science, University of Illinois at Chicago College of Nursing, Peoria, Illinois
    2. Teverbaugh, Croland, & Mueller OB/GYN & Associates, Peoria, Illinois
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  • Barbara Camune DrPH, APN, CNM, WHNP-BC, FACNM (Clinical Associate Professor),

    1. University of Illinois at Chicago College of Nursing, Peoria, Illinois
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  • Kathleen Baldwin PhD, RN (Director),

    1. Peoria Obstetrical & Gynecologic Group at Methodist Medical Center, Peoria, Illinois
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  • James K. Crane MD, MPH, FACOG (Obstetrical Hospitalist)

    1. Peoria Obstetrical & Gynecologic Group at Methodist Medical Center, Peoria, Illinois
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  • Disclosures: The authors report no competing interests.

Diane L. Dunniway, DNP, APN, WHNP-BC, University of Illinois at Chicago College of Nursing, Peoria Regional Program, One Illini Drive, Peoria, IL 61604.
Tel: 309-868-9644; Fax: 309-671-8436; E-mail: ddunni1@uic.edu

Abstract

Abstract  Purpose: To evaluate the use of FRAX® (Fracture risk assessment tool) for changes in bone health risk factors and treatment decision-making.

Data Sources: A convenience sample of seventeen women, 50 years and older, English-speaking, generally healthy, with the ability to perform weight-bearing exercise, presenting for a DXA scan in a Midwestern city between August 2009 and November 2009, and not already being treated for osteoporosis or osteopenia. Self-administered diet and exercise questionnaires were completed by participants, followed by individual counseling related to FRAX® absolute risk and NOF guidelines. Questionnaires were repeated at approximately three months later, along with a short survey regarding the information's impact.

Conclusions: FRAX® increased a participant's perception of future risk for osteoporosis and desire to change bone health habits. About 50% actually made changes in calcium and vitamin D consumption and weight-bearing exercise. FRAX® could not be applied to those with osteopenia of the spine only; and a variety of bone health risk factors not covered by FRAX® were identified.

Implications for Practice: The FRAX® risk assessment tool can be useful to motivate clients to change bone health behavior. However, it has limitations in its use as a tool for whether or not to prescribe bisphosphonates.

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