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 .
Treatment of Osteoporotic Vertebral Compression Fractures: Applicability of Appropriateness Criteria in Clinical Practice.
BACKGROUND Appropriate treatment choice for osteoporotic vertebral compression fractures ( OVCF ) is challenging due to patient heterogeneity . Using the R AND /UCLA method , an international multidisciplinary expert panel established patient-specific criteria for the choice between non-surgical management ( NSM ) , vertebroplasty ( VP ) , and balloon kyphoplasty ( BKP ) . OBJECTIVES To assess the applicability of the appropriateness criteria in real-life practice . STUDY DESIGN Prospect i ve observational study . SETTING Eight practice s of experts who participated in the panel study , including 2 interventional radiologists , one internal medicine specialist , 2 neurosurgeons , and 3 orthopedic/trauma surgeons . Practice s were located in Belgium , Germany , Italy , Switzerl and , and the United Kingdom . METHODS Using an online data capture program , participants documented the clinical profile  ( age , gender  , previous VCFs , time since fracture , magnetic resonance imaging ( MRI ) findings , evolution of symptoms , impact of symptoms on quality of life , spinal deformity , ongoing fracture process , and presence of pulmonary dysfunction ) and treatment choice for consecutive patients who consulted them for OVCF . RESULTS In total 426 patients were included .  BKP was the most frequently chosen treatment option ( 49 % ) , followed by VP ( 34 % ) and NSM ( 14 % ) . When compared with the panel recommendations , inappropriate treatment choices were rare ( 5 % for NSM , 2 % for VP , none for BKP ) . Treatment choice was strongly associated with the clinical variables used in the panel study . Differences in treatment decisions between interventional radiologists and surgeons were largely determined by differences in patient characteristics , with time of clinical presentation being the dominant factor . LIMITATION The study population was restricted to the practice s of the participants of the panel study . CONCLUSION This international , multi-specialty utilization review showed excellent applicability of , and good adherence with R AND /UCLA-based recommendations on treatment choice in OVCF
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 .