Background/Purpose: We conducted a 6-month multi-centered, open-label, parallel, randomized control trial to compare a multimedia-patient education tool (MM-PtET) including storylines and narratives with a written booklet for participants with osteoporosis (OP).

Methods: 225 participants were recruited from 3 outpatient clinics and newspaper advertisement. Inclusion criteria were: (i) diagnosis of osteoporosis/osteopenia, (ii) female gender, (iii) age ≥50 years (iv) at least 3 years post-menopausal, (v) adequate cognitive status, and (vi) ability to communicate in English or Spanish language. Participants were randomized through an institutional web system to either a MM-PtET or a written booklet with same content as MM-PtET. All participants completed questionnaire at baseline (pre and post), 3 and 6 months. Primary outcome measures included: disease knowledge, decisional conflict, and role preferences. Secondary outcomes were: self-efficacy and disease management.

Results: 111 participants were randomly allocated to the MM-PtET intervention and 114 to the control booklet. Mean age of participants was 64±9 years and 82% had adequate health literacy. 183 (85=MM-PtET, 98=booklet) and 189 (90=MM-PtET, 99=booklet) participants returned their questionnaires at 3 and 6 months, respectively.  Within groups most outcomes were improved from baseline to 3 and 6 months.  At 6 months, more participants in the MM-PtET group switched from active to passive role preference after watching the MM-PtET compared to patients reading the booklet (11% vs 3%, p=0.03). Results from linear regression on the difference between baseline and 6 month scores showed that younger age (p=0.03, p=NS, p=0.04) and receiving booklet among patients with inadequate health literacy levels (p= 0.02, p=0.009, p=0.05, p=0.02) were associated with greater improvements in the total decision conflict scale, uninformed, and clarity subscales, and self-efficacy.  In contrast, receiving MM-PtET among patients with adequate health literacy levels led to greater improvements in the uninformed subscale (p=0.03).  Greater improvements in the effective disease management scale were associated with younger age (p=0.03). Generalized estimating equation analysis showed that after adjusting for correlated outcome data and controlling for other variables, patients who received the intervention had higher odds of active role preference for disease management if they belonged to the inadequate health literacy group (p=0.02).  Also, the odds of active role preference among participants receiving the intervention are higher than controls but the magnitude decreases with longer disease duration (p=0.004).

Conclusion: Regardless of the delivery method, patients improve outcomes with educational materials up to 6 months after being informed. Participants with either adequate or inadequate health literacy levels improved outcomes with the MM-PtET.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/improving-outcomes-with-a-multimedia-patient-education-tool-in-patients-with-osteoporosis-after-6-months-a-randomized-controlled-trial/