دورية أكاديمية
Osteoporosis Improvement: A Large-Scale Randomized Controlled Trial of Patient and Primary Care Physician Education
| العنوان: | Osteoporosis Improvement: A Large-Scale Randomized Controlled Trial of Patient and Primary Care Physician Education |
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| المؤلفون: | Solomon, Daniel H, Katz, Jeffrey N, Finkelstein, Joel S, Polinski, Jennifer M, Stedman, Margaret, Brookhart, M Alan, Arnold, Marilyn, Gauthier, Suzanne, Avorn, Jerry |
| المصدر: | Journal of Bone and Mineral Research ; volume 22, issue 11, page 1808-1815 ; ISSN 0884-0431 1523-4681 |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2007 |
| مصطلحات موضوعية: | Orthopedics and Sports Medicine, Endocrinology, Diabetes and Metabolism |
| الوصف: | We conducted a randomized controlled trial within the setting of a large drug benefit plan for Medicare beneficiaries. Primary care physicians and their patients were randomized to usual care, patient intervention only, physician intervention only, or both interventions. There was no difference in the probability of the primary composite endpoint (BMD test or osteoporosis medication) or in either of its components comparing the combined intervention group with usual care (risk ratio = 1.04; 95% CI, 0.85–1.26). Introduction: Fractures from osteoporosis are associated with substantial morbidity, mortality, and cost. However, only a minority of at-risk older adults receives screening and/or treatment for this condition. We evaluated the effect of educational interventions for osteoporosis targeting at-risk patients, primary care physicians, or both. Materials and Methods: We conducted a randomized controlled trial within the setting of a large drug benefit plan for Medicare beneficiaries. Primary care physicians and their patients were randomized to usual care, patient intervention only, physician intervention only, or both interventions. The at-risk patients were women ≥65 yr of age, men and women ≥65 yr of age with a prior fracture, and men and women ≥65 yr of age who used oral glucocorticoids. The primary outcome studied was a composite of either undergoing a BMD test or initiating a medication used for osteoporosis. The secondary outcome was a hip, humerus, spine, or wrist fracture. Results: We randomized 828 primary care physicians and their 13,455 eligible at-risk patients into four study arms. Physician and patient characteristics were very similar across all four groups. Across all four groups, the rate of the composite outcome was 10.3 per 100 person-years and did not differ between the usual care and the combined intervention groups (p = 0.5). In adjusted Cox proportional hazards models, there was no difference in the probability of the primary composite endpoint comparing the combined ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1359/jbmr.070717 |
| الإتاحة: | https://doi.org/10.1359/jbmr.070717Test https://academic.oup.com/jbmr/article-pdf/22/11/1808/56551199/5650221121.pdfTest |
| حقوق: | https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_modelTest |
| رقم الانضمام: | edsbas.F9CCD1E2 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1359/jbmr.070717 |
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