2016
DOI: 10.1007/s00198-016-3681-9
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Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial

Abstract: Summary Patients often do not know or understand their bone density test results, and pharmacological treatment rates are low. In a clinical trial of 7749 patients, we used a tailored patient-activation result letter accompanied by a bone health brochure to improve appropriate pharmacological treatment. Treatment rates, however, did not improve. Introduction Patients often do not know or understand their dual-energy x-ray absorptiometry (DXA) test results, which may lead to suboptimal care. We tested whether… Show more

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Cited by 23 publications
(42 citation statements)
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“…The PAADRN CONSORT patient flow chart and descriptive baseline data for the covariates have previously been described [14]. Approximately 54% (7749) of the 14,280 patients known to be eligible for the study consented to participate and were enrolled.…”
Section: Resultsmentioning
confidence: 99%
See 2 more Smart Citations
“…The PAADRN CONSORT patient flow chart and descriptive baseline data for the covariates have previously been described [14]. Approximately 54% (7749) of the 14,280 patients known to be eligible for the study consented to participate and were enrolled.…”
Section: Resultsmentioning
confidence: 99%
“…Follow-up interviews were completed by 86.8% at 12 weeks post-DXA and by 77.7% at 52 weeks post-DXA. Because previous analyses [14] of these data have shown that using inverse probability of treatment weighting (IPTW) to adjust for potential attrition bias associated with loss to follow-up have yielded comparable results to those obtained when only complete cases were analyzed, here we used the latter approach because it is more straightforward.…”
Section: Resultsmentioning
confidence: 99%
See 1 more Smart Citation
“…The algorithm for determining guideline-concordant pharmacologic treatment was based on the 2010 National Osteoporosis Foundation guidelines in effect at the time of the PAADRN study 26 and is described in detail elsewhere. 27 Essentially, the algorithm is based on the 2-by-2 cross-classification of whether the patient was taking osteoporosis pharmacologic treatment (bisphosphonates, calcitonin, estrogen/hormone therapy, estrogen agonist/antagonist, parathyroid hormone, or denosumab) and whether this was guideline-concordant. In this pilot RCT, guideline-concordant pharmacotherapy was measured only at 52 weeks after enrollment.…”
Section: Guideline-concordant Pharmacotherapymentioning
confidence: 99%
“…41 On other outcomes (eg, guideline-concordant pharmacotherapy, total calcium Vitamin D supplementation, frequency of weightbearing and strengthening exercise), the PAADRN intervention was typically marginally better than usual care over a 52-week period. 27,42 Two other integrated delivery systems that conducted RCTs of similar nurse consultations found somewhat more encouraging results. In a Geisinger Health System study, a brief nurse consultation with periodic phone follow-up found no improvements in osteoporosis pharmacologic treatment at 12 months compared with a control group, although, patients who received nurse consultation reported significant increases in calcium intake and exercise frequency compared with the control group.…”
Section: Original Research and Contributionsmentioning
confidence: 99%