Community based intervention to optimize osteoporosis management: randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Osteoporosis-related fractures are a significant public health concern. Interventions that increase detection and treatment of osteoporosis are underutilized. This pragmatic randomised study was done to evaluate the impact of a multi...

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Main Authors: Ciaschini Patricia M, Straus Sharon E, Dolovich Lisa R, Goeree Ron A, Leung Karen M, Woods Carol R, Zimmerman Greg M, Majumdar Sumit R, Spadafora Silvana, Fera Luke A, Lee Hui N
Format: Article
Language:English
Published: BMC 2010-08-01
Series:BMC Geriatrics
Online Access:http://www.biomedcentral.com/1471-2318/10/60
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author Ciaschini Patricia M
Straus Sharon E
Dolovich Lisa R
Goeree Ron A
Leung Karen M
Woods Carol R
Zimmerman Greg M
Majumdar Sumit R
Spadafora Silvana
Fera Luke A
Lee Hui N
author_facet Ciaschini Patricia M
Straus Sharon E
Dolovich Lisa R
Goeree Ron A
Leung Karen M
Woods Carol R
Zimmerman Greg M
Majumdar Sumit R
Spadafora Silvana
Fera Luke A
Lee Hui N
author_sort Ciaschini Patricia M
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Osteoporosis-related fractures are a significant public health concern. Interventions that increase detection and treatment of osteoporosis are underutilized. This pragmatic randomised study was done to evaluate the impact of a multifaceted community-based care program aimed at optimizing evidence-based management in patients at risk for osteoporosis and fractures.</p> <p>Methods</p> <p>This was a 12-month randomized trial performed in Ontario, Canada. Eligible patients were community-dwelling, aged ≥55 years, and identified to be at risk for osteoporosis-related fractures. Two hundred and one patients were allocated to the intervention group or to usual care. Components of the intervention were directed towards primary care physicians and patients and included facilitated bone mineral density testing, patient education and patient-specific recommendations for osteoporosis treatment. The primary outcome was the implementation of appropriate osteoporosis management.</p> <p>Results</p> <p>101 patients were allocated to intervention and 100 to control. Mean age of participants was 71.9 ± 7.2 years and 94% were women. Pharmacological treatment (alendronate, risedronate, or raloxifene) for osteoporosis was increased by 29% compared to usual care (56% [29/52] vs. 27% [16/60]; relative risk [RR] 2.09, 95% confidence interval [CI] 1.29 to 3.40). More individuals in the intervention group were taking calcium (54% [54/101] vs. 20% [20/100]; RR 2.67, 95% CI 1.74 to 4.12) and vitamin D (33% [33/101] vs. 20% [20/100]; RR 1.63, 95% CI 1.01 to 2.65).</p> <p>Conclusions</p> <p>A multi-faceted community-based intervention improved management of osteoporosis in high risk patients compared with usual care.</p> <p>Trial Registration</p> <p>This trial has been registered with clinicaltrials.gov (ID: NCT00465387)</p>
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spelling doaj.art-d34ba1eba2b848e6a0bbd9e097f116522022-12-22T01:05:59ZengBMCBMC Geriatrics1471-23182010-08-011016010.1186/1471-2318-10-60Community based intervention to optimize osteoporosis management: randomized controlled trialCiaschini Patricia MStraus Sharon EDolovich Lisa RGoeree Ron ALeung Karen MWoods Carol RZimmerman Greg MMajumdar Sumit RSpadafora SilvanaFera Luke ALee Hui N<p>Abstract</p> <p>Background</p> <p>Osteoporosis-related fractures are a significant public health concern. Interventions that increase detection and treatment of osteoporosis are underutilized. This pragmatic randomised study was done to evaluate the impact of a multifaceted community-based care program aimed at optimizing evidence-based management in patients at risk for osteoporosis and fractures.</p> <p>Methods</p> <p>This was a 12-month randomized trial performed in Ontario, Canada. Eligible patients were community-dwelling, aged ≥55 years, and identified to be at risk for osteoporosis-related fractures. Two hundred and one patients were allocated to the intervention group or to usual care. Components of the intervention were directed towards primary care physicians and patients and included facilitated bone mineral density testing, patient education and patient-specific recommendations for osteoporosis treatment. The primary outcome was the implementation of appropriate osteoporosis management.</p> <p>Results</p> <p>101 patients were allocated to intervention and 100 to control. Mean age of participants was 71.9 ± 7.2 years and 94% were women. Pharmacological treatment (alendronate, risedronate, or raloxifene) for osteoporosis was increased by 29% compared to usual care (56% [29/52] vs. 27% [16/60]; relative risk [RR] 2.09, 95% confidence interval [CI] 1.29 to 3.40). More individuals in the intervention group were taking calcium (54% [54/101] vs. 20% [20/100]; RR 2.67, 95% CI 1.74 to 4.12) and vitamin D (33% [33/101] vs. 20% [20/100]; RR 1.63, 95% CI 1.01 to 2.65).</p> <p>Conclusions</p> <p>A multi-faceted community-based intervention improved management of osteoporosis in high risk patients compared with usual care.</p> <p>Trial Registration</p> <p>This trial has been registered with clinicaltrials.gov (ID: NCT00465387)</p>http://www.biomedcentral.com/1471-2318/10/60
spellingShingle Ciaschini Patricia M
Straus Sharon E
Dolovich Lisa R
Goeree Ron A
Leung Karen M
Woods Carol R
Zimmerman Greg M
Majumdar Sumit R
Spadafora Silvana
Fera Luke A
Lee Hui N
Community based intervention to optimize osteoporosis management: randomized controlled trial
BMC Geriatrics
title Community based intervention to optimize osteoporosis management: randomized controlled trial
title_full Community based intervention to optimize osteoporosis management: randomized controlled trial
title_fullStr Community based intervention to optimize osteoporosis management: randomized controlled trial
title_full_unstemmed Community based intervention to optimize osteoporosis management: randomized controlled trial
title_short Community based intervention to optimize osteoporosis management: randomized controlled trial
title_sort community based intervention to optimize osteoporosis management randomized controlled trial
url http://www.biomedcentral.com/1471-2318/10/60
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