Literature DB >> 18521649

A demonstration project of a multi-component educational intervention to improve integrated post-fracture osteoporosis care in five rural communities in Ontario, Canada.

S B Jaglal1, G Hawker, V Bansod, N M Salbach, M Zwarenstein, J Carroll, D Brooks, C Cameron, E Bogoch, L Jaakkimainen, H Kreder.   

Abstract

UNLABELLED: This study evaluated a multi-component intervention (educational materials and outreach visits) to increase knowledge and improve post-fracture care management in five rural communities in Canada. One hundred and twenty-five patients pre- intervention and 149 post-intervention were compared. No significant improvement in post-fracture care was documented suggesting that a more targeted intervention is needed.
INTRODUCTION: Currently, the majority of patients with a low trauma fracture are under-investigated and under-treated for osteoporosis. We set out to evaluate an educational intervention on increasing knowledge of post-fracture care among health care professionals (HCPs) and fracture patients and on improving post-fracture management.
METHODS: We studied five rural communities in Ontario, Canada, using a multi-component intervention ("Behind the Break"), including educational material for HCPs and patients and educational outreach visits to physicians. The study had a historical control, non-equivalent pre/post design. Telephone surveys were carried out with individuals > or =40 years of age who had a low trauma fracture in 2003 (n = 125) or in 2005 (n = 149). Family physicians and emergency department staff were also surveyed.
RESULTS: A total of 4,207 educational packages were distributed. Seventy-three percent of family physicians had an outreach visit. Two-thirds indicated that they received enough information about post-fracture follow-up to incorporate it into their practice. Despite this, no significant improvement in post-fracture care was documented (32% in the "pre" group had a bone mineral density test and 25% in the "post" group). Of those diagnosed with osteoporosis, the majority were prescribed a bone-sparing medication (63% "pre" and 80% "post").
CONCLUSION: A more targeted intervention linking fracture patients to their physician needs to be evaluated in rural communities.

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Mesh:

Year:  2008        PMID: 18521649     DOI: 10.1007/s00198-008-0654-7

Source DB:  PubMed          Journal:  Osteoporos Int        ISSN: 0937-941X            Impact factor:   4.507


  43 in total

1.  Principles of educational outreach ('academic detailing') to improve clinical decision making.

Authors:  S B Soumerai; J Avorn
Journal:  JAMA       Date:  1990-01-26       Impact factor: 56.272

2.  A randomized controlled trial of mailed osteoporosis education to older adults.

Authors:  D H Solomon; J S Finkelstein; J M Polinski; M Arnold; A Licari; D Cabral; C Canning; J Avorn; J N Katz
Journal:  Osteoporos Int       Date:  2006-01-24       Impact factor: 4.507

3.  Cancer: improving early detection and prevention. A community practice randomised trial.

Authors:  A J Dietrich; G T O'Connor; A Keller; P A Carney; D Levy; F S Whaley
Journal:  BMJ       Date:  1992-03-14

4.  The inpatient consultation approach to osteoporosis treatment in patients with a fracture. Is automatic consultation needed?

Authors:  Elizabeth A Streeten; Asif Mohamed; Amish Gandhi; Denise Orwig; Paul Sack; Robert Sterling; Vincent D Pellegrini
Journal:  J Bone Joint Surg Am       Date:  2006-09       Impact factor: 5.284

5.  Osteoporosis disease management in a rural health care population: hip fracture reduction and reduced costs in postmenopausal women after 5 years.

Authors:  E D Newman; W T Ayoub; R H Starkey; J M Diehl; G C Wood
Journal:  Osteoporos Int       Date:  2003-02-18       Impact factor: 4.507

6.  Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial.

Authors:  Sumit R Majumdar; Jeffrey A Johnson; Finlay A McAlister; Debbie Bellerose; Anthony S Russell; David A Hanley; Don W Morrish; Walter P Maksymowych; Brian H Rowe
Journal:  CMAJ       Date:  2008-02-26       Impact factor: 8.262

7.  Electronic medical record reminder improves osteoporosis management after a fracture: a randomized, controlled trial.

Authors:  Adrianne Feldstein; Patricia J Elmer; David H Smith; Michael Herson; Eric Orwoll; Chuhe Chen; Mikel Aickin; Martha C Swain
Journal:  J Am Geriatr Soc       Date:  2006-03       Impact factor: 5.562

8.  The awareness-to-adherence model of the steps to clinical guideline compliance. The case of pediatric vaccine recommendations.

Authors:  D E Pathman; T R Konrad; G L Freed; V A Freeman; G G Koch
Journal:  Med Care       Date:  1996-09       Impact factor: 2.983

9.  Improving care of patients at-risk for osteoporosis: a randomized controlled trial.

Authors:  Daniel H Solomon; Jennifer M Polinski; Margaret Stedman; Colleen Truppo; Laura Breiner; Catherine Egan; Saira Jan; Minal Patel; Thomas W Weiss; Ya-ting Chen; M Alan Brookhart
Journal:  J Gen Intern Med       Date:  2007-03       Impact factor: 5.128

10.  The design of a valid and reliable questionnaire to measure osteoporosis knowledge in women: the Osteoporosis Knowledge Assessment Tool (OKAT).

Authors:  Tania M Winzenberg; Brian Oldenburg; Sue Frendin; Graeme Jones
Journal:  BMC Musculoskelet Disord       Date:  2003-07-24       Impact factor: 2.362

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  14 in total

1.  Accident or osteoporosis?: Survey of community follow-up after low-trauma fracture.

Authors:  Sonia Singh; Ramona Foster; Karim M Khan
Journal:  Can Fam Physician       Date:  2011-04       Impact factor: 3.275

2.  Osteoporosis knowledge translation for young adults: new directions for prevention programs.

Authors:  Alyson Holland
Journal:  Health Promot Chronic Dis Prev Can       Date:  2017-08       Impact factor: 3.240

3.  Closing the gap in postfracture care at the population level: a randomized controlled trial.

Authors:  William D Leslie; Lisa LaBine; Penny Klassen; Darlene Dreilich; Patricia A Caetano
Journal:  CMAJ       Date:  2011-12-19       Impact factor: 8.262

Review 4.  Coordinator-based systems for secondary prevention in fragility fracture patients.

Authors:  D Marsh; K Akesson; D E Beaton; E R Bogoch; S Boonen; M-L Brandi; A R McLellan; P J Mitchell; J E M Sale; D A Wahl
Journal:  Osteoporos Int       Date:  2011-05-24       Impact factor: 4.507

5.  Identifying characteristics of an effective fracture liaison service: systematic literature review.

Authors:  C-H Wu; C-H Chen; P-H Chen; J-J Yang; P-C Chang; T-C Huang; S Bagga; Y Sharma; R-M Lin; D-C Chan
Journal:  Osteoporos Int       Date:  2018-03-10       Impact factor: 4.507

6.  The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population-based randomized controlled trial.

Authors:  L Bessette; K S Davison; S Jean; S Roy; L G Ste-Marie; J P Brown
Journal:  Osteoporos Int       Date:  2011-02-11       Impact factor: 4.507

7.  Bone quality: educational tools for patients, physicians, and educators.

Authors:  Junaid Shams; Allison B Spitzer; Ann M Kennelly; Laura L Tosi
Journal:  Clin Orthop Relat Res       Date:  2011-08       Impact factor: 4.176

8.  Secondary prevention of osteoporotic fractures--an "OPTIMAL" model of care from Singapore.

Authors:  M Chandran; M Z W Tan; M Cheen; S B Tan; M Leong; T C Lau
Journal:  Osteoporos Int       Date:  2013-04-25       Impact factor: 4.507

9.  Patient perceptions of provider barriers to post-fracture secondary prevention.

Authors:  J E M Sale; E Bogoch; G Hawker; M Gignac; D Beaton; S Jaglal; L Frankel
Journal:  Osteoporos Int       Date:  2014-08-01       Impact factor: 4.507

10.  [Economic concepts for measuring the costs of illness of osteoporosis: an international comparison].

Authors:  K Viktoria Stein; Thomas Dorner; Kitty Lawrence; Michael Kunze; Anita Rieder
Journal:  Wien Med Wochenschr       Date:  2009-05
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