An Effective Team Approach to Improve Postoperative Hip Fracture Care

Piziak, Veronica; Rajab, M. Hasan

doi:10.1097/bot.0b013e3181db703c

Cited by 12 publications

(9 citation statements)

References 16 publications

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“…[ 20 ] Increasing rate of osteoporosis medication in patient with hip fracture use beyond 6 months of the intervention ranged from 16% to 34.1% ( Table 2 ). [ 14 15 16 17 18 19 ] Our findings are corresponded with other previous reports. In this study, comparing with control group, increasing rate of anti-osteoporosis medication was increased by 17.2% and medication persistence was 40.2% at the 12 months follow-up.…”

Section: Discussionsupporting

confidence: 92%

“…Several interventional studies for improving osteoporosis management following hip fracture have demonstrated that patients and/or physicians education can lead to improvement of initiation rate of anti-osteoporosis medications in patients with hip fracture. [ 14 15 16 17 18 19 ] Previously, we performed interventional study for improving orthopaedic surgeon awareness and reported an improved medication rate of osteoporosis from 15% to 32% in patients with hip fracture. [ 12 ] However, 32% of the osteoporosis treatment rate at six months following hip fracture was still lower than other intervention studies.…”

Section: Discussionmentioning

confidence: 99%

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Improvement of Osteoporosis Medication after Multimodal Intervention in Patients with Hip Fracture: Prospective Multicenter Study

et al. 2018

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BackgroundThe authors had earlier conducted a retrospective cohort study from 2008 to 2011 in Jeju Island, among 945 hip fracture patients above 50 years of age. Of these 945 patients, 344 patients (36.4%) underwent a bone mineral density test and 218 patients (23.1%) received treatment for osteoporosis. The purpose of this study was to determine whether a patient education program could improve osteoporosis management after hip fracture. The data of the previous study was used for comparison.MethodsFrom November 1, 2014 to September 30, 2015, 190 patients above 50 years of age who were admitted for hip fractures at six different hospitals, were enrolled in the present study. During the hospitalization period, patients underwent education sessions and were provided brochures. Patients were evaluated for diagnosis and treatment of osteoporosis at six months after discharge and were followed-up for at least a year.ResultsOf the 222 patients with hip fractures, 190 patients (37 men, 153 women) were enrolled at six hospitals in 2015. Dual energy X-ray absorptiometry was performed on 115 patients (60.5%) and 92 patients (48.4%) were prescribed medication for osteoporosis at the time of discharge. A total of 43.7% and 40.2% of the patients were found to be compliant with osteoporosis medication at 6 months and 12 months follow-up respectively.ConclusionsThis interventional multicenter study demonstrated that a patient education program in patients with hip fractures can improve compliance to osteoporosis medication up to 12 months of follow-up.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Improvement of Osteoporosis Medication after Multimodal Intervention in Patients with Hip Fracture: Prospective Multicenter Study

et al. 2018

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“…There are several studies that demonstrate that coordination between the orthopedic and endocrinology services, especially with outpatient management, leads to improved outcomes. 8 , 13 , 28 - 31 One system that has shown success has been the Kaiser Southern California Healthy Bones Program. The deployment of an aggressive bone health program that facilitated the management of osteoporosis in patients with recent fragility fractures with the referral of complex patients to endocrinology was able to reduce the number of hip fractures by 37%.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Insurance Type on Fragility Fracture Patient Access to Endocrinology Under the Affordable Care Act

Wiznia

Ndon

Kim

et al. 2016

Geriatr Orthop Surg Rehabil

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Objectives:To assess the effect of insurance type (Medicaid, Medicare, and private insurance) on fragility fracture patients’ access to endocrinology specialists in the postoperative period.Materials and Methods:The research team called 247 board-certified endocrinologists in 8 representative states. The caller requested an appointment for her fictitious mother to be evaluated for osteoporosis after suffering a hip fracture that required surgery. The caller stated that her mother had an abnormal level of parathyroid hormone and her mother’s orthopedic surgeon believed she needed to see an endocrinologist. Each office was called 3 times to assess the responses for each insurance type. For each call, we documented whether the patient was able to receive an appointment and the barriers the patient confronted to receiving an appointment.Results:About 15.8% of offices scheduled an appointment for a patient with Medicaid, compared to 48.6% for Medicare and 54.3% for BlueCross (P < .0001). Medicaid patients confronted more barriers to receiving appointments. There was no statistically significant difference in access for Medicaid patients in states that had expanded Medicaid versus states that had not expanded Medicaid. Medicaid reimbursement for a new level 3 patient visit did not significantly correlate with appointment success rates or wait times.Conclusion:Despite the passage of the Affordable Care Act, Medicaid patients have reduced access to endocrinologists and more complex barriers to receiving appointments. A more robust strategy for increasing access to care for Medicaid patients would be more equitable.

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“…¤ A prospective cohort study evaluated the effect of multispecialty inpatient care on the treatment of osteoporosis in 137 patients with a hip fracture 20 .…”

Section: Femurmentioning

confidence: 99%

What’s New in Orthopaedic Trauma

Ricci

Gardner

et al. 2012

Journal of Bone and Joint Surgery

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An Effective Team Approach to Improve Postoperative Hip Fracture Care

Abstract: The addition of a calcium/vitamin D supplement and an endocrinology appointment to the hospital discharge orders was an effective method of improving treatment and enhancing compliance.

Cited by 12 publications

References 16 publications

Improvement of Osteoporosis Medication after Multimodal Intervention in Patients with Hip Fracture: Prospective Multicenter Study

Improvement of Osteoporosis Medication after Multimodal Intervention in Patients with Hip Fracture: Prospective Multicenter Study

The Effect of Insurance Type on Fragility Fracture Patient Access to Endocrinology Under the Affordable Care Act

What’s New in Orthopaedic Trauma

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