Pilot study of 10-year absolute fracture risk assessment tool (FRAX®) introduction into the structure of undegraduate practical training "physician assistant” course

Abstract

Background: high fracture rates throughout the Eastern Europe and Central Asia region have been reported. Major fractures rate increasing, primary care physicians need to be aware of risk assessment and prevention tools. Aims: The aim of this pilot study was to assess main issues of FRAX tool introduction into undergraduate medical education. Material and methods: Russian version of the IOF approved presentation on FRAX application procedure, results assessment and interpretation as well as Russian Association for Osteoporosis clinical guidelines and reference to www.osteoporoz.ru site have been provided to 248 undergraduate medical students. To increase osteoporosis related issues study motivation the students were asked to apply the Russian version of on-line FRAX calculator to assess risk fracture in their close relatives of appropriate age. Also the students were asked to create a FRAX assessment based patient management program. Results: 207 FRAX assessment reports were received as feedback. Derived intervention threshold was reached in 41 cases (19.8%), while in 45 reports (21.7%) body mass index (BMI) value was mistaken for a 10-year fracture risk. There were 123 cases of the students parents assessments. These subjects appeared to be quite young (median 48, range 42 62) and relatively healthy to report no fracture risk factors. The students grandparents or great-grandparents (68 cases) were assessed on rare occasions due to lack of information or absence of personal contacts between students and their relatives. The students reported appreciable difficulties in decision making. Lifestyle and diet modification were not included in 165 of recommendations, while calcium and vitamin D prescriptions were severely biased by TV advertising. The students reported that it was quite difficult for them to give the patients recommendations regarding the choice of drug and administration timeframe. Conclusion: pilot study of FRAX introduction into undergraduate medical education helped to ascertain several gaps in teaching of osteoporosis diagnosis, prevention and treatment to be covered during undergraduate medical education

Keywords

• osteoporosis
• risk assessment
• inpatients
• outpatients
• education
• medical
• undergraduate