The impact of bone mineral density testing, fracture assessment, and osteoporosis education in men treated by androgen deprivation for prostate cancer: a pilot study

Support Care Cancer. 2014 Sep;22(9):2409-15. doi: 10.1007/s00520-014-2183-6. Epub 2014 Apr 3.

Abstract

Purpose: Men receiving androgen deprivation therapy for prostate cancer have low knowledge of osteoporosis (OP) and engage in few healthy bone behaviors (HBBs). A multicomponent intervention was piloted in this population. Changes in OP knowledge, self-efficacy, health beliefs, and engagement in HBBs were evaluated.

Methods: A pre-post pilot study was performed in a convenience sample of men recruited from the Princess Margaret Cancer Centre. Men were sent personalized letters explaining their dual x-ray absorptiometry (DXA) results and fracture risk assessment with an OP-related education booklet. Participants completed questionnaires assessing OP knowledge, self-efficacy, health beliefs, and current engagement in HBBs at baseline (T1) and 3 months post-intervention (T2). Paired t tests and McNemar's test were used to assess changes in outcomes.

Results: A total of 148 men completed the study. There was an increase in OP knowledge (9.7 ± 4.3 to 11.4 ± 3.3, p < 0.0001) and feelings of susceptibility (16.5 ± 4.3 to 17.4 ± 4.7, p = 0.015), but a decrease in total self-efficacy (86.3 ± 22.9 to 81.0 ± 27.6, p = 0.007) from baseline to post-intervention. Men made appropriate changes in their overall daily calcium intake (p ≤ 0.001), and there was uptake of vitamin D supplementation from 44 % (n = 65) to 68 % (n = 99) (p < 0.0001). Men with bone loss (osteopenia or OP) had a greater change in susceptibility (1.9 ± 4.3 vs. -0.22 ± 4.2, p = 0.005) compared to men with normal bone density.

Conclusions: Our results provide preliminary evidence that a multicomponent intervention such as the one described can lead to increased knowledge and feelings of susceptibility regarding OP and can enhance uptake of some HBBs.

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Aged, 80 and over
  • Androgen Antagonists / adverse effects*
  • Androgen Antagonists / therapeutic use
  • Bone Density*
  • Fractures, Bone / diagnostic imaging*
  • Fractures, Bone / etiology
  • Humans
  • Knowledge
  • Male
  • Middle Aged
  • Osteoporosis / chemically induced*
  • Osteoporosis / complications
  • Osteoporosis / diagnostic imaging*
  • Patient Education as Topic*
  • Pilot Projects
  • Prostatic Neoplasms / drug therapy*
  • Self Efficacy

Substances

  • Androgen Antagonists