The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population-based randomized controlled trial

Bessette, Louis; Davison, K. Shawn; Jean, Sonia; Ste-Marie, Line; Brown, Jacques P.

doi:10.1007/s00198-011-1533-1

Cited by 37 publications

(22 citation statements)

References 32 publications

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“…Osteoporosis is a skeletal disease characterized by bone mass loss and microarchitectural deterioration of bone tissues, which increases bone fragility and fracture susceptibility [1][2][3][4][5]. The disease affects millions of men and women, especially among aging populations.…”

Section: Introductionmentioning

confidence: 99%

Reduced serum corin levels in patients with osteoporosis

Zhou

Liu

Zhu

et al. 2013

Clinica Chimica Acta

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Section: Introductionmentioning

confidence: 99%

Reduced serum corin levels in patients with osteoporosis

Zhou

Liu

Zhu

et al. 2013

Clinica Chimica Acta

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“…Показано, что обучение, направленное на врачей, не увеличивает приверженность лечению среди пациентов [26,27]. Пассивные формы обучения пациентов в виде лекции, брошюры или просмотра видеофильма также дают невысокие результаты [27,28,29]. Более эффективными являются программы с интерактивным обучением [30,31].…”

Section: Discussionunclassified

Comparative Effectiveness of Various Educational Programs in Osteoporosis

Yevstigneyeva¹,

Евстигнеева²,

Kuznetsova³

et al. 2015

Osteopor Bone Dis

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Background: educational programs may be beneficial in a variety of important factors for the prevention, treatment and management of osteoporosis. Objectives: to evaluate the influence of the three different educational interventions on knowledge, dietary calcium, physical activities and adherence to treatment of osteoporosis. Methods: 117 patients (middle age 63.3 ± 8.1 years old, 95.7% are women) with osteoporosis have been included in this study. All patients were randomized to three groups. The patients of intervention group (n=39) had an osteoporosis school program (4 lessons with using interactive methods in groups of 5-8 patients). The patients of the control group (n=38) received brochures with general information about osteoporosis. The patients of the comparison group(n=40) received lecture (1 x 1.5 h) about osteoporosis. Average changes from baseline in knowledge, dietary calcium, physical activities and time of physical exercises was evaluated in 3, 6 and 12 months. Adherence to treatment was evaluated in 12 months. Results: After educational programs level of knowledge was increased in patients of the intervention group in 3, 6 and 12 months by 23,8%, 22,9%, 21,1%, in the group of brochures - by 0.5%, 1.8%, 4.7%, correspondingly, p<0.01. In the group, who received lecture level of knowledge was increased by 18.0%, 15.8%, 14.6% (р<0.05 when compared with the brochure at visits 3 and 6 months). The using of dietary calcium was increased in 3, 6 and 12 months in the intervention group by 188.5 mg, 211.8 mg and 238.1 mg. In group,whoreceivedbrochuresby 146.8 mg, 106.4 mg, 84.4 mg, in group,whoreceived lecture by 66.0 mg, 80.4 mg and 68.3 mg (p<0.05when compared intervention group with the group,who received lecture at visits 3 months).Physical activity was increased in 3, 6 and 12 months in intervention group by 1.7, 1.9, 0.9 scores and was significantly higher, than in group,whoreceived lecture(0.2, 0.2, 0.1 scores) and in control group,whoreceived brochures(0.1, 0.2, 0 scores). Time of physical exercises was increased by 45.1, 54.2 и 49.9 min in week in the intervention group and was significantly more than in the groups,whoreceived lecture or brochures. Adherence to pathogenetic osteoporosis treatment was higher in the intervention group: 56.4% of intervention group, and 30.0% of the group,whoreceived lecture, and 13.2% of group,whoreceived brochures took pathogenetic medication regularly during the year (p<0.01when compared the intervention group with the control group). Conclusions: educational program with using interactive methods in small groups increases knowledge about of osteoporosis, dietary calcium,physicalactivities and increases adherence to treatment of pathogenetic medication more than brochure and lecture.

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“…About one-third of studies reported pharmaceutical company funding. (25,(27)(28)(29)(35)(36)(37)(38)43,50,(56)(57)(58)60,64) Study quality and potential sources of bias Study quality assessment findings are shown in Supplemental Table S3. In every bias domain category evaluated, most studies were assessed as having unclear risk of bias.…”

Section: Study Characteristicsmentioning

confidence: 99%

How Can We Improve Osteoporosis Care? A Systematic Review and Meta-Analysis of the Efficacy of Quality Improvement Strategies for Osteoporosis

Nayak

Greenspan

2018

Journal of Bone and Mineral Research

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Although osteoporosis affects 10 million people in the United States, screening and treatment rates remain low. We performed a systematic review and meta-analysis of the efficacy of quality improvement strategies to improve osteoporosis screening (bone mineral density [BMD]/dual-energy X-ray absorptiometry [DXA] testing) and/or treatment (pharmacotherapy) initiation rates. We developed broad literature search strategies for PubMed, Embase, and Cochrane Library databases, and applied inclusion/exclusion criteria to select relevant studies. Random-effects meta-analyses were performed for outcomes of BMD/DXA testing and/or osteoporosis treatment. Forty-three randomized clinical studies met inclusion criteria. For increasing BMD/DXA testing in patients with recent or prior fracture, meta-analyses demonstrated several efficacious strategies, including orthopedic surgeon or fracture clinic initiation of osteoporosis evaluation or management (risk difference 44%, 95% confidence interval [CI] 26%-63%), fracture liaison service/case management (risk difference 43%, 95% CI 23%-64%), multifaceted interventions targeting providers and patients (risk difference 24%, 95% CI 15%-32%), and patient education and/or activation (risk difference 16%, 95% CI 6%-26%). For increasing osteoporosis treatment in patients with recent or prior fracture, meta-analyses demonstrated significant efficacy for interventions of fracture liaison service/case management (risk difference 20%, 95% CI 1%-40%) and multifaceted interventions targeting providers and patients (risk difference 12%, 95% CI 6%-17%). The only quality improvement strategy for which meta-analysis findings demonstrated significant improvement of osteoporosis care for patient populations including individuals without prior fracture was patient self-scheduling of DXA plus education, for increasing the outcome of BMD testing (risk difference 13%, 95% CI 7%-18%). The meta-analyses findings were limited by small number of studies in each analysis; high between-study heterogeneity; sensitivity to removal of individual studies; and unclear risk of bias of included studies. Despite the limitations of the current body of evidence, our findings indicate there are several strategies that appear worthwhile to enact to try to improve osteoporosis screening and/or treatment rates. © 2018 American Society for Bone and Mineral Research.

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The impact of two educational interventions on osteoporosis diagnosis and treatment after fragility fracture: a population-based randomized controlled trial

Abstract: The educational interventions assessed in this trial were not satisfactory to increase osteoporosis diagnosis or treatment in recently fractured women to a clinically meaningful degree.

Cited by 37 publications

References 32 publications

Reduced serum corin levels in patients with osteoporosis

Reduced serum corin levels in patients with osteoporosis

Comparative Effectiveness of Various Educational Programs in Osteoporosis

How Can We Improve Osteoporosis Care? A Systematic Review and Meta-Analysis of the Efficacy of Quality Improvement Strategies for Osteoporosis

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