Interventions to improve OP management had a significant positive impact on prescription of BMD measurement but a more limited impact on treatment prescription
Osteoporosis ( OP ) is a major public health concern , but still OP care does not meet guidelines .
Interventions have been developed to improve appropriate OP management .
The objective of the present study was to systematic ally review the current literature to ascertain the efficacy of interventions to improve OP care and characterize interventions taking into account elements related to their potential cost and feasibility .
Educating nursing home staff on fracture prevention: a cluster randomised trial.
OBJECTIVE to assess whether  specialist osteoporosis nurses  delivering training to care home staff can reduce fractures and improve the prescription of treatments to reduce fractures versus usual care . DESIGN pragmatic cluster r and omised controlled trial ( RCT ) with r and omisation at the Primary Care Organisation ( PCO ) level . SETTING care homes ( residential , nursing and EMI ) across Engl and and Wales within PCOs . PARTICIPANTS all 300 PCOs in Engl and and Wales were invited to take part . Of these , 58 agreed to participate and gained ethical approval in time to start the study : 29 clusters were r and omised to the intervention group and 29 to the control . INTERVENTION specialist osteoporosis nurses undertaking short training sessions with care home staff emphase the importance of fracture and fall prevention and train staff on how to identify those residents at high risk of fracture . Residents ' risk of fracture and falls was reported to general practitioners ( GPs ) of patients along with treatment recommendations . OUTCOME MEASURES primary outcome measures were total fractures over the past 12 months and total hip fractures over past the 12 months . Secondary outcome measures were total home falls , number of residents sustaining a fall , number of residents prescribed bisphosphonates , number of residents prescribed calcium and vitamin D and number of residents wearing hip protectors . All outcomes were measured at the care home level . RESULTS of the 230 care homes r and omised data were collected from 209 of these containing 5,637 residents . There were no differences between the groups in the incidence rate ratios ( IRRs ) for total fractures ( IRR = 0.94 [ 0.71 , 1.26 ] P = 0.70 ) or total hip fractures ( IRR = 0.86 [ 0.63 , 1.18 ] P = 0.36 ) . No differences were found between groups for home falls or hip protector use . A significant increase in  bisphosphonate prescription was seen in the intervention group over the control group ( IRR = 1.50 [ 1.00 , 2.24 ] P = 0.05 ) .  Calcium and vitamin D prescription was significantly increased in the intervention group over the control group ( IRR = 1.64 [ 1.23 , 2.18 ] P<0.01 ) . CONCLUSION the intervention significantly increased the prescription of bisphosphonates and calcium/vitamin D , but was not associated with a significant effect on the rate of falls or fractures
Interventions to improve OP management had a significant positive impact on prescription of BMD measurement but a more limited impact on treatment prescription
Osteoporosis ( OP ) is a major public health concern , but still OP care does not meet guidelines .
Interventions have been developed to improve appropriate OP management .
The objective of the present study was to systematic ally review the current literature to ascertain the efficacy of interventions to improve OP care and characterize interventions taking into account elements related to their potential cost and feasibility .