Patient knowledge, beliefs, and behavior concerning the prevention and treatment of glucocorticoid-induced osteoporosis

Objective. To obtain descriptive information concerning the extent to which patients taking oral glucocorticoids recall receiving osteoporosis prevention counseling, and to identify factors associated with the practice of 3 behaviors (i.e., calcium intake, vitamin D intake, and bone mineral density [BMD] testing) recommended for patients receiving glucocorticoid therapy. Methods. The study assessed cross-sectional data derived from telephone interviews and mailed questionnaires completed by 227 patients who were currently taking oral prednisone. Questions assessed current calcium and vitamin D intake and history of BMD testing. Results. Approximately one-third of participants (36.3%) reported that they had received osteoporosis prevention counseling. Among those who reported receiving counseling, most (73.2%) remembered being told about the importance of obtaining an adequate amount of calcium. Other topics were remembered less frequently. Slightly more than half of study participants (51.1%) were obtaining the recommended amount of calcium. Fewer were obtaining the recommended amount of vitamin D (35.2%) or had received a BMD test within the past year (33.5%). The most consistent predictors of behavior were counseling status and patients' perceptions of the difficulty associated with performing the behavior. Conclusion. Most patients receiving oral glucocorticoids receive insufficient counseling concerning the prevention of osteoporosis; patients either are not being counseled or they are being counseled in a manner that is not sufficient to promote subsequent recall and behavior change. Research is needed to develop effective strategies to educate patients about the prevention of glucocorticoid-induced osteoporosis.