Patients’ Experiences of Nurse Case-Managed Osteoporosis Care: A Qualitative Study

Abstract

Background: Osteoporosis is a chronic condition that is often left untreated. Nurse case-managers can double rates of appropriate treatment in those with new fractures. However, little is known about patients’ experiences of a nurse case-managed approach to osteoporosis care. Objective: Our aim was to describe patients’ experiences of nurse case-managed osteoporosis care. Methods: A qualitative, descriptive design was used. We recruited patients enrolled in a randomized controlled trial of a nurse case-management approach. Individual semi-structured interviews were conducted which were transcribed and analyzed using content analysis. Data were managed with ATLAS.ti version 7. Results: We interviewed 15 female case-managed patients. Most (60%) were 60-years or older, 27% had previous fracture, 80% had low bone mineral density tests, and 87% had good osteoporosis knowledge. Three major themes emerged from our analysis: acceptable information to inform decision-making; reasonable and accessible care provided; and appropriate information to meet patient needs. Conclusions: This study provides important insights about older female patients’ experiences with nurse case-managed care for osteoporosis. Our findings suggest that this model to osteoporosis clinical care should be sustained and expanded in this setting, if proven effective. In addition, our findings point to the importance of applying patient-centered care across all dimensions of quality to better enhance the patients’ experience of their health care.

Application Effect of Case Management Mode Combined with ERAS in Elderly Patients with Hip Fracture

“…Case management mode is a cooperative, systematic, and flexible disease management mode. Through the evaluation of patients' conditions, effective communication, coordination, and reasonable allocation of resources, professional medical staff provide patients with integrated and personalized nursing services, so as to effectively improve the quality of care for patients [ 14 ]. The case management mode will follow up the medical care from the patient's hospital admission to discharge, from the ward to the home, and give them care and help in every detail.…”

Caring for adults with hip pain

“…Home care to reduce fall hazards includes good lighting, clearing obstructions, and making sure floors are not slick 17. Patients tend to trust expert care from nurses and appreciate the personalized information regarding their bone health in these specialized clinics 25. Nurses can take the time needed to provide education related to treatment options, supplements, diet, and exercise 25…”

“…Nutritional supplements aimed at decreasing the incidence of osteoporosis include calcium and vitamin D 25. Nurses should be aware of the recommended amounts of calcium and vitamin D in women and men at different ages starting at 19 years (see Calcium and vitamin D recommendations ).…”

“…Education should be provided for all patients who have been prescribed a drug therapy that may decrease or interfere with the absorption of calcium and lead to a risk for osteoporosis and subsequent bone fractures. Patients can benefit from nurse case-managed care osteoporosis clinics where nurses offer in-person education, counseling, and guideline-based treatments 25. Fall prevention strategies should be included in the instruction provided.…”

Bone and Joint Health Strategic Clinical Network

“…Findings to date showed that the secondary prevention programs are cost-effective (an estimated $9200 per qualityadjusted life-year compared with usual care) 9 and are acceptable to patients, providing appropriate care and information upon which to make decisions. 10 Results are outlined in the BJH SCN's annual report, 6 and research publications are forthcoming.…”