Abstract
Summary
We conducted a randomized controlled trial to compare the efficacy of adding a video tool to a printed booklet on osteoporosis. Both strategies were effective in increasing knowledge and decreasing decisional conflict. There was no difference in the measured outcomes between the intervention and control groups. Patient preferences and learning styles are key factors in deciding a presentation format when educating patients with osteoporosis.
Introduction
Innovative approaches to patient education about self-management in osteoporosis may improve outcomes.
Methods
We conducted a randomized controlled trial to compare the efficacy of adding a multimedia patient education tool involving video modeling to a printed educational booklet on osteoporosis. Participants were post-menopausal women with osteoporosis. We assessed osteoporosis knowledge, decisional conflict, self-efficacy, and effectiveness in disease management at baseline, immediately post-intervention, and at 3 and 6 months. Linear regression models were used to explore changes in outcomes at 6 months with respect to baseline characteristics.
Results
Two hundred and twenty-five women were randomized, 111 to receive the multimedia tool in addition to the booklet and 114 to receive the booklet alone. Knowledge and decisional conflict scores significantly improved in both groups at all post-intervention assessment points, but with no significant differences in score changes between the groups. Self-efficacy and disease management effectiveness showed no significant changes from baseline. In the entire cohort, younger age was associated with better effectiveness in disease management and Hispanic women had greater gains in knowledge at 6 months compared to White women. Women with limited health literacy who had received the multimedia tool in addition to the printed materials had higher decisional conflict than those who received printed materials alone.
Conclusion
Both multimedia and printed tools increased knowledge and decreased decisional conflict to the same extent, neither of the educational materials proved to be better than the other. For women with limited health literacy, receiving the booklet alone was more effective in reducing decisional conflict after 6 months, than adding the multimedia tool.
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Acknowledgments
We are grateful to Vincent Richards from The University of Texas MD Anderson Cancer Center, for his contributions during the acquisition of the data, to Kenneth Saag from The University of Alabama at Birmingham School of Public Health and Amye Leong from Healthy Motivation and the Global Alliance for Musculoskeletal Health of the Bone and Joint Decade, for the input provided during the development of the multimedia patient education tool. We are also grateful to Andrea Barbo for her assistance in data analysis.
Funding
This study was supported by a grant from The Agency for Healthcare Research and Quality’s (AHRQ) (Award Number: 1R18HS019354-03). Clinicaltrials.gov NCT no. NCT01698762.
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Contributions
Dr Suarez-Almazor had full access to all of the data in the study and takes responsibility for the integrity and the accuracy of the data analysis.
Study concept and design: Suarez-Almazor, Volk.
Acquisition of data: Lopez-Olivo, Richards, des Bordes.
Analysis and interpretation of data: Suarez-Almazor, Lopez-Olivo, des Bordes, Rizvi.
Drafting of the manuscript: des Bordes, Lopez-Olivo, Lin, Rizvi, Suarez-Almazor.
Critical revision of the manuscript for important intellectual content: Suarez-Almazor, Lopez-Olivo, des Bordes, Lin, Rizvi, Volk
Statistical analysis: Lin.
Obtained funding: Suarez-Almazor.
Administrative, technical, or material support: Suarez-Almazor, Lopez-Olivo.
Study supervision: Suarez-Almazor.
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Conflicts of interest
Maria A. Lopez-Olivo, Jude des Bordes, Heather Lin, Tara Rizvi, Robert Volk declare that they have no conflict of interest.
Maria E. Suarez-Almazor has received consulting fees from Abbvie, Pfizer Inc., Eli Lilly and Agile Therapeutics, unrelated to the content of this publication.
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Appendix
Appendix
Uniform Resource Locators (URLs) to access the multimedia patient education tool.
English:
Spanish:
https://mediaplayer.mdanderson.org/video-full/75918AE9-359D-4EA6-B241-C5A154C142F7
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Lopez-Olivo, M., des Bordes, J., Lin, H. et al. Comparison of multimedia and printed patient education tools for patients with osteoporosis: a 6-month randomized controlled trial. Osteoporos Int 31, 857–866 (2020). https://doi.org/10.1007/s00198-019-05210-4
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DOI: https://doi.org/10.1007/s00198-019-05210-4