Protocol for the <it>Osteoporosis Choice </it>trial. A pilot randomized trial of a decision aid in primary care practice
<p>Abstract</p> <p>Background</p> <p>Bisphosphonates can reduce fracture risk in patients with osteoporosis, but many at-risk patients do not start or adhere to these medications. The aims of this study are to: (1) preliminarily evaluate the effect of an individualized...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2009-12-01
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| Series: | Trials |
| Online Access: | http://www.trialsjournal.com/content/10/1/113 |
| _version_ | 1819140362697965568 |
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| author | Tulledge-Scheitel Sidna M Kesman Rebecca L Breslin Maggie Swiglo Brian A Mullan Rebecca J Shah Nilay D Van Houten Holly K Campbell Megan E Pencille Laurie J Jaeger Thomas M Johnson Ruth E Bartel Gregory A Wermers Robert A Melton L Joseph Montori Victor M |
| author_facet | Tulledge-Scheitel Sidna M Kesman Rebecca L Breslin Maggie Swiglo Brian A Mullan Rebecca J Shah Nilay D Van Houten Holly K Campbell Megan E Pencille Laurie J Jaeger Thomas M Johnson Ruth E Bartel Gregory A Wermers Robert A Melton L Joseph Montori Victor M |
| author_sort | Tulledge-Scheitel Sidna M |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Bisphosphonates can reduce fracture risk in patients with osteoporosis, but many at-risk patients do not start or adhere to these medications. The aims of this study are to: (1) preliminarily evaluate the effect of an individualized 10-year osteoporotic fracture risk calculator and decision aid (<it>O<smcaps>STEOPOROSIS CHOICE</smcaps></it>) for postmenopausal women at risk for osteoporotic fractures; and (2) assess the feasibility and validity (i.e., absence of contamination) of patient-level randomization (vs. cluster randomization) in pilot trials of decision aid efficacy.</p> <p>Methods/Design</p> <p>This is a protocol for a parallel, 2-arm, randomized trial to compare an intervention group receiving <it>O<smcaps>STEOPOROSIS CHOICE </smcaps></it>to a control group receiving usual primary care. Postmenopausal women with bone mineral density T-scores of <-1.0, not receiving bisphosphonate therapy, and receiving care at participating primary care practices in and around Rochester, Minnesota, USA will be eligible to participate in the trial. We will measure the effect of O<smcaps>STEOPOROSIS CHOICE</smcaps> on five outcomes: (a) patient knowledge regarding osteoporosis risk factors and treatment; (b) quality of the decision-making process for both the patient and clinician; (c) patient and clinician acceptability and satisfaction with the decision aid; (d) rate of bisphosphonate use and adherence, and (e) trial processes (e.g., ability to recruit participants, collect patient outcomes). To capture these outcomes, we will use patient and clinician surveys following each visit and video recordings of the clinical encounters. These video recordings will also allow us to determine the extent to which clinicians previously exposed to the decision aid were able to recreate elements of the decision aid with control patients (i.e., contamination). Pharmacy prescription profiles and follow-up phone interviews will assess medication start and adherence at 6 months.</p> <p>Discussion</p> <p>This pilot trial will provide evidence of feasibility, validity of patient randomization, and preliminary efficacy of a novel approach -- decision aids -- to improving medication adherence for postmenopausal women at risk of osteoporotic fractures. The results will inform the design of a larger trial that could provide more precise estimates of the efficacy of the decision aid.</p> <p>Trial registration</p> <p>Clinical Trials.gov Identifier: NCT00578981</p> |
| first_indexed | 2024-12-22T11:37:21Z |
| format | Article |
| id | doaj.art-8d1088a035ff4c73a353be1004de7346 |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-12-22T11:37:21Z |
| publishDate | 2009-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-8d1088a035ff4c73a353be1004de73462022-12-21T18:27:23ZengBMCTrials1745-62152009-12-0110111310.1186/1745-6215-10-113Protocol for the <it>Osteoporosis Choice </it>trial. A pilot randomized trial of a decision aid in primary care practiceTulledge-Scheitel Sidna MKesman Rebecca LBreslin MaggieSwiglo Brian AMullan Rebecca JShah Nilay DVan Houten Holly KCampbell Megan EPencille Laurie JJaeger Thomas MJohnson Ruth EBartel Gregory AWermers Robert AMelton L JosephMontori Victor M<p>Abstract</p> <p>Background</p> <p>Bisphosphonates can reduce fracture risk in patients with osteoporosis, but many at-risk patients do not start or adhere to these medications. The aims of this study are to: (1) preliminarily evaluate the effect of an individualized 10-year osteoporotic fracture risk calculator and decision aid (<it>O<smcaps>STEOPOROSIS CHOICE</smcaps></it>) for postmenopausal women at risk for osteoporotic fractures; and (2) assess the feasibility and validity (i.e., absence of contamination) of patient-level randomization (vs. cluster randomization) in pilot trials of decision aid efficacy.</p> <p>Methods/Design</p> <p>This is a protocol for a parallel, 2-arm, randomized trial to compare an intervention group receiving <it>O<smcaps>STEOPOROSIS CHOICE </smcaps></it>to a control group receiving usual primary care. Postmenopausal women with bone mineral density T-scores of <-1.0, not receiving bisphosphonate therapy, and receiving care at participating primary care practices in and around Rochester, Minnesota, USA will be eligible to participate in the trial. We will measure the effect of O<smcaps>STEOPOROSIS CHOICE</smcaps> on five outcomes: (a) patient knowledge regarding osteoporosis risk factors and treatment; (b) quality of the decision-making process for both the patient and clinician; (c) patient and clinician acceptability and satisfaction with the decision aid; (d) rate of bisphosphonate use and adherence, and (e) trial processes (e.g., ability to recruit participants, collect patient outcomes). To capture these outcomes, we will use patient and clinician surveys following each visit and video recordings of the clinical encounters. These video recordings will also allow us to determine the extent to which clinicians previously exposed to the decision aid were able to recreate elements of the decision aid with control patients (i.e., contamination). Pharmacy prescription profiles and follow-up phone interviews will assess medication start and adherence at 6 months.</p> <p>Discussion</p> <p>This pilot trial will provide evidence of feasibility, validity of patient randomization, and preliminary efficacy of a novel approach -- decision aids -- to improving medication adherence for postmenopausal women at risk of osteoporotic fractures. The results will inform the design of a larger trial that could provide more precise estimates of the efficacy of the decision aid.</p> <p>Trial registration</p> <p>Clinical Trials.gov Identifier: NCT00578981</p>http://www.trialsjournal.com/content/10/1/113 |
| spellingShingle | Tulledge-Scheitel Sidna M Kesman Rebecca L Breslin Maggie Swiglo Brian A Mullan Rebecca J Shah Nilay D Van Houten Holly K Campbell Megan E Pencille Laurie J Jaeger Thomas M Johnson Ruth E Bartel Gregory A Wermers Robert A Melton L Joseph Montori Victor M Protocol for the <it>Osteoporosis Choice </it>trial. A pilot randomized trial of a decision aid in primary care practice Trials |
| title | Protocol for the <it>Osteoporosis Choice </it>trial. A pilot randomized trial of a decision aid in primary care practice |
| title_full | Protocol for the <it>Osteoporosis Choice </it>trial. A pilot randomized trial of a decision aid in primary care practice |
| title_fullStr | Protocol for the <it>Osteoporosis Choice </it>trial. A pilot randomized trial of a decision aid in primary care practice |
| title_full_unstemmed | Protocol for the <it>Osteoporosis Choice </it>trial. A pilot randomized trial of a decision aid in primary care practice |
| title_short | Protocol for the <it>Osteoporosis Choice </it>trial. A pilot randomized trial of a decision aid in primary care practice |
| title_sort | protocol for the it osteoporosis choice it trial a pilot randomized trial of a decision aid in primary care practice |
| url | http://www.trialsjournal.com/content/10/1/113 |
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