Telemedicine for Osteoporosis Follow-Up: Clinical Effectiveness and Patient Satisfaction: a Retrospective Cohort Study

Background: Osteoporosis is a significant global health issue due to its association with fragility fractures, which can lead to chronic pain, disability, reduced quality of life, and increased healthcare costs. Regular follow-up is crucial in managing osteoporosis to monitor bone mineral density (BMD), ensure medication adherence, and adjust treatment plans. However, barriers such as long travel distances, mobility issues, and resource limitations often prevent patients—especially the elderly—from attending in-person follow-up visits. Telemedicine has emerged as a promising alternative to bridge these gaps by providing remote access to care. Objective: This study aimed to evaluate the clinical effectiveness and patient satisfaction of telemedicine follow-up compared to traditional face-to-face visits in osteoporosis management. Specifically, changes in BMD and FRAX scores were compared, along with patient-reported satisfaction. Methods: A retrospective cohort study was conducted at Chiang Mai University Hospital, a tertiary referral center in Northern Thailand. The study included 195 patients diagnosed with osteoporosis who had received both face-to-face follow-ups during 2018–2019 and telemedicine visits between 2020–2023. Data collected included demographic information, BMD values (lumbar spine and femoral neck), FRAX scores, prescribed osteoporosis medications, and patient satisfaction ratings. Statistical analyses were performed using SPSS. Results: The study population had a median age of 73.4 years and a median BMI of 22.2 kg/m², with the majority being Thai females. Risk factors such as chronic steroid use (2.5%), smoking (3.1%), and alcohol use (1%) were infrequent. Most patients received calcium (70.2%) and vitamin D (68.2%), while bisphosphonates (52.5%), denosumab (36.6%), and teriparatide (4.1%) were also prescribed. There were no statistically significant differences in BMD or FRAX score changes between the two groups. Patient satisfaction was high in both groups, with a trend toward higher satisfaction in the telemedicine group. Satisfaction levels were strongly influenced by travel distance: patients living >10 km from the hospital preferred telemedicine, while those <5 km favored in-person visits (p < 0.001). Conclusion: Telemedicine follow-up produced clinical outcomes comparable to traditional care and achieved high patient satisfaction. It represents a viable model for osteoporosis management, particularly for patients with limited access to healthcare facilities.