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

Purpose: To evaluate the use of FRAX (R) (Fracture risk assessment tool) for changes in bone health risk factors and treatment decision-making. Data Sources: 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 (R) absolute risk and NOF guidelines. Questionnaires were repeated at approximately three months later, along with a short survey regarding the information's impact. Conclusions: FRAX (R) 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 (R) could not be applied to those with osteopenia of the spine only; and a variety of bone health risk factors not covered by FRAX (R) were identified. Implications for Practice: The FRAX (R) 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.