Please select the eligibility criteria that correspond to the clinical trial below.
Title: Closing the Post Fracture Care Gap in Manitoba
Brief Summary: The objective of this study is to evaluate a post-fracture intervention for improving osteoporosis care in older men and women who have suffered a fracture that may indicate the presence of osteoporosis. Although osteoporosis can be identified with a bone mineral density (BMD) test, most individuals with osteoporosis are not diagnosed until they fracture. Post-fracture care often "falls between the cracks" when there is a breakdown in communication between hospital and community, or between specialists and primary care physicians. Often physicians and patients fail to make the connection between an acute fracture and osteoporosis, or the value of secondary prevention strategies. If untreated, there is an extremely high rate of additional fractures after a first osteoporotic fracture. It follows that improving BMD testing and/or treatment in appropriately identified individuals is a necessary step in optimizing post-fracture patient care. Over the next three years we will be testing and optimizing a notification procedure to physicians and/or patients relying upon fracture events reported to the provincial health service (Manitoba Health).


Options:
A: Inclusion Criteria:

* Women and men age 50 and older with one of the following fracture definitions:

  * Hip fracture (physician ICD-9-CM 820-821 plus a procedure code for site-specific fracture reduction or fixation, open or closed)
  * Spine fracture (physician ICD-9-CM code 805), or
  * Humerus fracture (physician ICD-9-CM code 812), or
  * Colles' fracture (physician ICD-9-CM code 813 plus a physician claim for site-specific fracture reduction or fixation, open or closed, or cast application).

Exclusion Criteria:

* Age less than 50.
* Non-Manitoba residents, cancelled Manitoba Health coverage, death or discharge to a personal care home.
* A fracture event in the previous 12 months meeting the study case definition (i.e., only a single notification per year is planned).
* Hip or wrist fractures without a procedure tariff.
* Current treatment with an osteoporosis medication.
* BMD testing within the preceding 3 years.
B: Inclusion Criteria:

* age \> 50 years
* any closed distal forearm fracture
* discharged home

Exclusion Criteria:

* unwilling or unable to provide consent
* admitted to hospital
* long term care resident
* residence outside Edmonton, Alberta
* unable to read and converse in English
* currently taking prescription osteoporosis treatment
C: Inclusion Criteria:

All patients 50 years of age or older with a wrist fracture who present to the Emergency Departments or Fracture Clinics at our two study sites will be eligible for study enrollment. Specifically:

1. Age 50 years or greater,
2. Any distal forearm fracture

Exclusion Criteria:

1. Unable to give simple informed consent,
2. Unwilling to participate in the study,
3. Unable to understand, read, or converse in English,
4. Place of residence outside Capital Health or longterm care facility,
5. Already receiving osteoporosis treatment with a bisphosphonate,
6. Previously documented allergy or intolerance to a bisphosphonate,
7. Currently enrolled in the pilot study or other osteoporosis study
D: Inclusion Criteria:

* Members of the Henry Ford Health System

Exclusion Criteria:

* Individuals who are not members of the Henry Ford Health System

Answer: A