Expired CME Article

Osteoporosis Self-management: Choices For Better Bone Health

Authors: Deborah T. Gold, PHD, Stuart L. Silverman, MD, FACP, FACR

Abstract

Despite recent pharmacologic advances in the prevention and treatment of osteoporosis, the disease remains incurable. Effective disease management ultimately lies in the hands of the individual patient, who must take responsibility for key health behaviors related to bone health. One behavior modification strategy that has proven effective, but which has not previously been applied to osteoporosis, is “self-management.” This article describes the principals, evolution, and initial outcomes of a new self-management program, Choices For Better Bone Health. Choices is a group education course directed to postmenopausal women who are at risk or already affected by osteoporosis, and has shown positive results in early evaluations.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. America’s bone health: the state of osteoporosis and low bone mass in our nation. 2002:Washington, DC: National Osteoporosis Foundation.
 
2. Orwoll ES, Bevan L. Phipps KR. Determinants of bone mineral density in older men. Osteoporos Int2000;11(10):815–821.
 
3. Orwoll ES. Osteoporosis in men. Endocrin Metab Clin North Am 1998;27(2):349 –367.
 
4. Silverman SL, Minshall ME, Shen W, et al. Health-Related Quality of Life Subgroup of the Multiple Outcomes of Raloxifene Evaluation Study. The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum 2001;44(11):2611–2619.
 
5. Fink HA, Ensrud KE, Nelson DB, et al. Disability after clinical fracture in postmenopausal women with low bone density: the fracture intervention trial (FIT). Osteoporos Int 2003;14(1):69 –76.
 
6. Lippuner K. Medical treatment of vertebral osteoporosis. Eur Spine J 2003;12 Suppl 2:S132–S141.
 
7. Miller P. Analysis of 1-year vertebral fracture risk reduction data in treatments for osteoporosis. South Med J 2003;96(5):478 –485.
 
8. Gold DT. The nonskeletal consequences of osteoporotic fractures. Psychologic and social outcomes.Rheum Dis Clin North Am 2001;27(1):255–262.
 
9. Holroyd KA, Creer TL, eds. Self-management of chronic disease: handbook of clinical interventions and research. Orlando, FL, Academic Press, 1986.
 
10. Schreurs KM, Colland VT, Kuijer RG, et al. Development, content, and process evaluation of a short self-management intervention in patients with chronic diseases requiring self-care behaviours. Patient Ed Counsel 2003;51(2):133–141.
 
11. Bandura A. Self-efficacy mechanism in human agency. Am Psychol 1982;37:122–147.
 
12. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs, NJ, Prentice Hall, 1986.
 
13. Beasley R, Cushley M, Holgate ST. A self management plan in the treatment of adult asthma.Thorax 1989;44:200 –204.
 
14. DiIorio C, Hennessy M, Manteuffel B. Epilepsy self-management: a test of a theoretical model. Nurs Res 1996;45(4):211–217.
 
15. Day JL, Bodmer CW, Dunn OM. Development of a questionnaire identifying factors responsible for successful self-management of insulin-treated diabetes. Diabet Med 1996;13(6):564 –573.
 
16. Sandstrom MJ, Keefe FJ. Self-management of fibromyalgia: the role of formal coping skills training and physical exercise training programs. Arthr Care Res 1998;11:432–447.
 
17. Barlow JH, Turner AP, Wright CC. Long-term outcomes of an arthritis self-management programme.Br J Rheum 1998;37(12):1315–1319.
 
18. Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms.Ann Behav Med 2003;26(1):1–7.
 
19. Gallant MP. The influence of social support on chronic illness self-management: a review and directions for research. Health Educ Behav 2003;30(2):170 –195.
 
20. Silverman SL, Gold DT, Miller BE. Alpha and Beta test of Choices for better bone health: an osteoporosis self-management course. J Bone Miner Res 2000;15:S561.
 
21. Gold DT, Conditt MK, Silverman SL, et al. Bone health behaviors and self-efficacy: an analysis based on Choices for better bone health. Gerontologist 2002;42:59.
 
22. Silverman SL, Gold DT, Conditt MK, et al. Bone health behaviors and self-efficacy: an analysis based on Choices for better bone health. J Bone Miner Res 2002;17:S272.