Osteoporosis | Osteoporosis Coordinator for Low Volume Community Hospitals
Osteoporosis research study
What is the primary objective of this study?
A Regional Osteoporosis Coordinator located at Women's College Hospital will follow-up with low trauma fracture patients from 30 smaller community hospitals across Ontario. To evaluate whether this quality improvement program can increase post-fracture osteoporosis care in these individuals, hospitals will be randomized to receive osteoporosis specific recommendations or falls prevention advice. Patients will be asked to complete two short telephone surveys about their recent fracture, risk factors, osteoporosis knowledge and diagnostic and treatment history. All patients in the falls prevention advice group will receive the osteoporosis specific recommendations 6 months after their fracture.
Who is eligible to participate?
Inclusion Criteria: 1. Cluster site (hospital) level: Hospitals with no dedicated osteoporosis coordinator that treat more than 60 patients/year in their Emergency Department and who have a Telehealth studio. 2. Patient level: Patients 40 years old and over (men and women) presenting with a low trauma fracture of the hip, forearm and wrist, rib(s), sternum, thoracic and lumbar spine, shoulder and upper arm, pelvis, lower leg and ankle. Subjects without previous medication as well as subjects on osteoporosis medication and presenting with a fracture will be included. Exclusion Criteria: 1. Hospitals that have an Osteoporosis Strategy fracture clinic coordinator 2. Fractures associated with major trauma; fractures due to malignancy
Which medical condition, disease, disorder, syndrome, illness, or injury is researched?
Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.
Behavioral:centralized osteoporosis coordinatorThe regional osteoporosis coordinator will phone fracture patients and counsel them about their risk of osteoporosis, reiterating messages in the print material. The coordinator will also follow-up with family physicians by phone and send them a patient-specific reminder that informs them that their patient has experienced a fracture and they are at high risk for future fracture. As part of the reminder, a set of evidence-based recommendations about appropriate BMD testing and treatment based on the recent Canadian guidelines will be included. If the patient does not have a family physician, the regional osteoporosis coordinator will facilitate referral to the MOP.
Behavioral:fall preventionFracture patients from hospitals receiving falls prevention advice will also be called by the osteoporosis regional coordinator. The patient will receive educational material and telephone counseling regarding fall prevention. During the call, patients will be encouraged to visit their family physician for fracture follow-up. They will not receive counseling or educational materials about osteoporosis at this time. Patients in the falls prevention group will receive the physician and patient osteoporosis program six months post-fracture.
Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.
1hospitals randomly allocated to receive physician and patient osteoporosis recommendations from the regional coordinator
2hospitals randomly allocated to receive falls prevention advice
Start Date: June 2007
Completed Date: December 2008
Primary Outcome: proportion of patients from the intervention group as compared to the control group that had "appropriate management" based on a composite of undergoing a BMD test and starting therapy within 6 months of fracture.
Secondary Outcome: osteoporosis knowledge, perceived susceptibility, self-efficacy, preventive behaviors
Study sponsors, principal investigator, and references
Principal Investigator: Susan B Jaglal PhD
Lead Sponsor: Ontario Ministry of Health and Long Term Care