Bone health

Amazon Alexa: a user-friendly boost to osteoporosis self-management

Associate Professor David Scott

A 6-month digital health osteoporosis self-management intervention delivered remotely via Amazon Alexa improves osteoporosis knowledge and falls self-efficacy.

A study presented at the ANZBMS meeting comprised 50 postmenopausal women on medication such as denosumab for their osteoporosis. The women were randomised to receive either 6 months of automated education sessions on medication, nutrition, and exercise for osteoporosis, broadcast via a provided voice-activated Amazon Alexa Echo Show in their home, or automated monthly emails only.

Associate Professor David Scott, from the School of Exercise & Nutrition Sciences at Deakin University, said the feasibility study found the women in the Alexa group demonstrated small but significantly greater improvements in the Osteoporosis Knowledge Assessment Tool (OKAT) than controls.

The proportion of women experiencing no problems performing usual activities at 6-months was significantly greater for the Alexa group compared with controls and the Modified Falls Efficacy Scale scores improved significantly for the Alexa group.

There was no difference between the groups in adherence to osteoporosis treatment or most quality of life domains.

Associate Professor Scott told the limbic that the hands-off, natural voice interaction with Alexa appeared to be acceptable to participants. Qualitative interviews showed women definitely wanted to engage with the intervention.

“They found the education helpful and the exercise program motivating,” he said.

Adherence to the prescribed exercise program – 3 sessions per week of home-based strength, balance and impact training – was high.

“It’s very much early days and all self-reported data but the next study will expand to include video conferencing to watch them do the sit-to-stand test which is a validated measure of exercise performance, and accelerometers to measure their physical activity, etcetera.”

“We certainly aren’t of the opinion that this is a one size fits all solution. We see this as perhaps part of a suite of options where people can have their Alexa device on the kitchen counter finding out something about calcium…and then something in their smart phone for when they go out later that might tell them to do a few extra steps.”

“The idea would be to build a whole platform that can support people to think about what they are doing in terms of their management of their osteoporosis.”

He said the program appeared to address concerns women had about their condition and to reinforce information they may have already been given.

“A lot of people get an osteoporosis diagnosis and might get handed a pamphlet… and they might get a reminder to get another dose of their medication in 6-12 months but they are not getting that information reinforced and that means they might not embed those behaviours which might make a difference in their osteoporosis.”

“When they see someone like Peter Ebeling coming on talking in language they can understand about why their medication is safe and why it’s good for them, they come away with a lot more confidence about their prescription and looking after their health.”

“This patient population are pretty open to these kinds of technologies and self management programs.”

Associate Professor Scott said a future iteration of the program could also provide more personalised information and be able to answer participant’s questions.

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