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

Abstract

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