Our findings from 55 RCTs and 18 sub-group meta-analyses showed that complex implementation interventions with multiple components consisting of at least education + feedback + follow-up significantly increased the initiation of osteoporosis medications , and interventions with at least education + follow-up significantly increased the initiation of osteoporosis investigations .
No significant impact was found for any type of intervention to reduce fracture .
Complex interventions that include at least education + follow-up or feedback have the most potential for increasing osteoporosis investigations and treatment .
Patient education appears to be an important component in osteoporosis disease management
Osteoporosis is affecting over 200 million people worldwide .
Despite available guidelines , care for these patients remains sub-optimal .
We developed an osteoporosis tool to address the multiple dimensions of chronic disease management .
Findings from its evaluation showed a significant increase from baseline in osteoporosis investigations and treatment , so we are revising this tool to include multiple chronic conditions including an up date of evidence about osteoporosis .
Our objectives were to conduct a systematic review of osteoporosis interventions in adults at risk for osteoporosis .
Challenges in improving the quality of osteoporosis care for long-term glucocorticoid users: a prospective randomized trial.
BACKGROUND In light of widespread undertreatment for glucocorticoid-induced osteoporosis ( GIOP ) , we design ed a group r and omized controlled trial to increase bone mineral density ( BMD ) testing and osteoporosis medication prescribing among patients receiving long-term glucocorticoid therapy .  METHODS Using administrative data bases of a large US health plan , we identified physicians who prescribed long-term glucocorticoid therapy to at least 3 patients . One hundred fifty-three participating physicians were r and omized to receive a 3-module Web-based GIOP intervention or control course . Intervention modules focused on GIOP management and incorporated case-based continuing medical education and personalized audit and feedback of GIOP management compared with that of the top 10 % of study physicians . In the year following the intervention , we compared rates of BMD testing and osteoporosis medication prescribing between intervention and control physicians . RESULTS Following the intervention , intent-to-treat analyses showed that 78 intervention physicians ( 472 patients ) vs 75 control physicians ( 477 patients ) had similar rates of BMD testing ( 19 % vs 21 % , P = .48 ; rate difference , -2 % ; 95 % confidence interval [ CI ] , -8 % to 4 % ) and osteoporosis medication prescribing ( 32 % vs 29 % , P = .34 ; rate difference , 3 % ; 95 % CI , -3 % to 9 % ) . Among 45 physicians completing all modules ( 343 patients ) , intervention physicians had numerically but not significantly higher rates of BMD testing ( 26 % vs 16 % , P = .04 ; rate difference , 10 % ; 95 % CI , 1%-20 % ) and bisphosphonate prescribing ( 24 % vs 17 % , P = .09 ; rate difference , 7 % ; 95 % CI , -1 % to 16 % ) or met a combined end point of BMD testing or osteoporosis medication prescribing ( 54 % vs 44 % , P = .07 ; rate difference , 10 % ; 95 % CI , -1 % to 21 % ) compared with control physicians . CONCLUSIONS In the main analysis , a Web-based intervention incorporating performance audit and feedback and case-based continuing medical education had no significant effect on the quality of osteoporosis care . However , dose-response trends showed that physicians with greater exposure to the intervention had higher rates of GIOP management . New cost-effective modalities are needed to improve the quality of osteoporosis care
Our findings from 55 RCTs and 18 sub-group meta-analyses showed that complex implementation interventions with multiple components consisting of at least education + feedback + follow-up significantly increased the initiation of osteoporosis medications , and interventions with at least education + follow-up significantly increased the initiation of osteoporosis investigations .
No significant impact was found for any type of intervention to reduce fracture .
Complex interventions that include at least education + follow-up or feedback have the most potential for increasing osteoporosis investigations and treatment .
Patient education appears to be an important component in osteoporosis disease management
Osteoporosis is affecting over 200 million people worldwide .
Despite available guidelines , care for these patients remains sub-optimal .
We developed an osteoporosis tool to address the multiple dimensions of chronic disease management .
Findings from its evaluation showed a significant increase from baseline in osteoporosis investigations and treatment , so we are revising this tool to include multiple chronic conditions including an up date of evidence about osteoporosis .
Our objectives were to conduct a systematic review of osteoporosis interventions in adults at risk for osteoporosis .