Evaluation of Patients’ Response Toward Osteoporosis Letter Intervention Versus Phone Call Plus Letter Intervention

Abstract

Introduction:The aim of this study was to compare the effectiveness of 2 interventions in prompting patients to obtain osteoporosis follow-up after a fracture. Our hypothesis was that a phone call plus letter would yield greater response toward osteoporosis evaluation versus a letter alone to patients after sustaining a fragility fracture.Materials and Methods:Prospective study randomized 141 patients age 50 years and older with a fragility fracture into 3 groups for comparison. Group 1 (letter only) patients received a letter 3 months after their diagnosis of fracture indicating their risk for osteoporosis and urging them to follow-up for evaluation. Group 2 (phone call plus letter) patients were contacted via phone 3 months after their diagnosis of fracture. A letter followed the phone call. Group 3 (control) patients were neither contacted via phone nor sent a letter. All groups were contacted via phone 6 months after their initial visit to determine if they followed up for evaluation.Results:In group 1, 23 (52.27%) of 44 had follow-up, and 21 (47.73%) of 44 did not follow-up. In group 2, 30 (62.5%) of 48 had follow-up, and 18 (37.50%) of 48 did not follow-up. In group 3, 6 (12.24%) of 49 had some sort of follow-up, and 43 (87.76%) of 49 did not have any follow-up. A statistical significance was achieved between group 3 (control) and both groups 1 and 2 with regard to follow-up (P < .0001). The results did not show a statistically significant difference between Groups 1 and 2, however, there was a trend toward improved response with a phone call plus letter (P = .321).Conclusion:A more personalized approach with a phone call plus follow-up letter to patients increased osteoporosis follow-up care by an additional 10%, however, this was not a statistically significant difference from just sending out a letter alone.

Impact of Pharmacist Contact via Telephone vs Letter on Rate of Acquisition of Naloxone Rescue Kits by Patients with Opioid use Disorder

“…9 Follow-up was more frequent in group 2 compared to group 1, although there was no statistically significant difference between the two groups (62.5% vs 52.27%; p ¼ 0.321). 9 Despite demonstrating an additive benefit of phone calls to letter campaigns, these studies did not demonstrate the drastic difference between the two groups that was found within this study. One explanation may revolve around the focus of the intervention, as these two studies required patients to agree to and present for a follow-up appointment or health screening.…”

“…8 O'Brien and colleagues compared different methods of outreach in prompting patients to obtain osteoporosis follow-up following a fracture. 9 The three contact groups studied included letter only (group 1), phone call followed by a letter (group 2), and no contact (group 3). 9 Follow-up was more frequent in group 2 compared to group 1, although there was no statistically significant difference between the two groups (62.5% vs 52.27%; p = 0.321).…”

“…9 The three contact groups studied included letter only (group 1), phone call followed by a letter (group 2), and no contact (group 3). 9 Follow-up was more frequent in group 2 compared to group 1, although there was no statistically significant difference between the two groups (62.5% vs 52.27%; p ¼ 0.321). 9 Despite demonstrating an additive benefit of phone calls to letter campaigns, these studies did not demonstrate the drastic difference between the two groups that was found within this study.…”

“…However, there are other examples of a phone call providing additive benefit to distribution of a letter or educational brochure. 8 , 9 Selva and colleagues evaluated the impact of a brief informative telephone call in addition to a letter on patient uptake of an invitation for free colorectal cancer screening. 8 A statistically significant absolute increase of 11% in participation rate was found in those receiving a telephone call prior to a letter.…”

Unexpected challenges to preventing falls in older adults: a mixed methods study of an emergency department-based falls prevention referral pilot project

“…The participation in the intervention group was much higher with 77%, which resulted 50% fracture reduction caused by recurrence of falls [14]. A study about follow-up after a fragility fracture with an osteoporosis intervention, found a trend towards better follow-up with a more personalized approach with a phone call in addition to an invitation letter [15]. Therefore, contacting patients a few days after the ED visit, might result in higher follow-up rates for fall prevention interventions and thereby less morbidity and mortality caused by falls.…”