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 .
Post-fracture care: do we need to educate patients rather than doctors? The PREVOST randomized controlled trial
Summary We conducted a multicenter , r and omized controlled trial to evaluate the impact of a population -based patient-centered post-fracture care program with a dedicated case manager , PREVention of OSTeoporosis ( PREVOST ) , on appropriate post-fracture osteoporosis management . We showed that , compared to usual care , BMD investigation post-fracture was significantly improved ( + 20 % ) by our intervention program . Introduction Our study aims to evaluate the impact of a population -based patient-centered post-fracture care program , PREVOST , on appropriate post-fracture care . Methods Multicenter , r and omized controlled trial enrolling 436 women aged 50 to 85 years and attending a French hospital , for a low-energy fracture of the wrist or humerus . R and omization was stratified by age , hospital department , and site of fracture . The intervention was performed by a trained case manager who interacted only with the patients , with repeated oral and written information about fragility fractures and osteoporosis management , and prompting them to visit their primary care physicians . Control group received usual care . The primary outcome was the initiation of an appropriate post-fracture care defined by Bone Mineral Density ( BMD ) and /or anti-osteoporotic treatment prescription at 6 months . Results At 6 months , 53 % of women in intervention group initiated a post-fracture care versus 33 % for usual care ( adjOR 2.35 , 95%CI [ 1.58–3.50 ] , p < 0.001 ) . Post-fracture care was more frequent after wrist than humerus fracture ( adjOR 1.93 , 95%CI [ 1.14–3.30 ] , p = 0.015 ) and decreased with age ( adjOR for 10 years increase 0.76 , 95%CI [ 0.61–0.96 ] , p = 0.02 ) . The intervention result ed in BMD prescription in 50 % of patients ( adjOR 2.10 , 95%CI [ 1.41–3.11 ] , p < 0.001 ) and in BMD performance in 41 % of patients ( adjOR 2.12 , 95%CI [ 1.40–3.20 ] , p < 0.001 ) versus 33 and 25 % for usual care , respectively . Having performed a BMD increased treatment prescription ; however , only 46 % of women with a low BMD requiring a treatment according to the French guidelines received a prescription . Conclusion A patient-centered care program with a dedicated case manager can significantly improve post-fracture BMD investigation
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 .