Patient education may be one of the most underused tools for improving population health outcomes, according to Rita Roy, MD, executive director of the National Spine Health Foundation.
“There are knowledge gaps on the patient education side and on the provider education side,” Dr. Roy said. “You can’t close a treatment gap if you haven’t figured out on the provider side why that gap exists.”
She pointed to osteoporosis and spine health as a case study in what happens when patients are left out of the education loop. Osteoporotic fractures occur more often in the spine than anywhere else in the body, yet studies suggest only about a third of vertebral fractures are ever clinically diagnosed, Dr. Roy said.
That gap, she said, comes down to a lack of awareness among spine surgeons — and a lack of any single specialty owning bone health.
“If you have a problem with your bones, where do you go?” Dr. Roy said. Patients get bounced between rheumatology, endocrinology, orthopedics and primary care, “and so what ends up happening is these patients fall through the cracks. Pun intended.”
An equally significant gap exists on the patient side, Dr. Roy said. Without knowledge of bone health, patients don’t understand how early-life factors such as nutrition, inactivity and hormonal changes shape their future fracture risk. She also pushed back on the public perception of who osteoporosis affects.
“We as a society think of osteoporosis as blue-haired old ladies in a wheelchair in a nursing home, and that’s not true,” she said.
Closing the gap requires educating patients directly, not just providers, Dr. Roy argued.
“If patients understand what they need to do to take care of their bones and why it matters, they will demand the treatment, and that will drive better policy and better treatment,” she said.
She pointed to the national push around high blood pressure awareness in the 1980s as evidence of what patient and caregiver advocacy can accomplish. “Patient advocacy drove public awareness and then policy change,” Dr. Roy said.
Musculoskeletal diagnoses carry one of the highest disease burdens of any condition tracked by the World Health Organization, Dr. Roy said, and she expects patient education to become more central to spine and musculoskeletal care.
“This is a disability. This is opioids. This is bone health. This is women’s health,” she said. As the population ages and older adults expect to stay active later in life, patients “need to be their own best self advocates, and that requires knowledge from people who are not selling you anything.”
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