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 .
Direct and Indirect Costs of Non-Vertebral Fracture Patients with Osteoporosis in the US
Background : Osteoporosis is a condition marked by low bone mineral density and the deterioration of bone tissue . One of the main clinical and economic consequences of osteoporosis is skeletal fractures . Objective : To assess the healthcare and work loss costs of US patients with non-vertebral ( NV ) osteoporotic fractures . Methods : Privately insured ( aged 18–64 years ) and Medicare ( aged ≥65 years ) patients with osteoporosis ( ICD-9-CM code : 733.0x ) were identified during 1999–2006 using two cl aims data bases . Patients with an NV fracture ( femur , pelvis , lower leg , upper arm , forearm , rib or hip ) were matched r and omly on age , sex , employment status and geographic region to controls with osteoporosis and no fractures . Patient characteristics and annual healthcare costs were assessed over the year following the index fracture for privately insured ( n = 4764 ) and Medicare ( n = 48 742 ) beneficiaries ( Medicare drug costs were estimated using multivariable models ) . Indirect ( i.e. work loss ) costs were calculated for a subset of privately insured , employed patients with available disability data ( n = 1148 ) . All costs were reported in $ US , year 2006 values . Results : In Medicare , mean incremental healthcare costs per NV fracture patient were $ US13 387 ( $ US22 466 vs $ US9079 ; p < 0.05 ) . The most expensive patients had index fractures of the hip , multiple sites and femur ( incremental costs of $ US25 519 , $ US20 137 and $ US19 403 , respectively ) . Patients with NV non-hip ( NVNH ) fractures  had incremental healthcare costs of $ US7868 per patient ( $ US16 704 vs $ US8836 ; p < 0.05 ) . Aggregate annual incremental healthcare costs of NVNH patients in the Medicare research sample ( n = 35 933 ) were $ US282.7 million compared with $ US204.1 million for hip fracture patients ( n = 7997).Among the privately insured , mean incremental healthcare costs per NV fracture patient were $ US5961 ( $ US11 636 vs $ US5675 ; p < 0.05 ) . The most expensive patients had index fractures of the hip , multiple sites and pelvis ( incremental costs of $ US13 801 , $ US9642 and $ US8164 , respectively ) . Annual incremental healthcare costs per NVNH patient were $ US5381 ( $ US11 090 vs $ US5709 ; p < 0.05 ) . Aggregate annual incremental healthcare costs of NVNH patients in the privately insured sample ( n = 4478 ) were $ US24.1 million compared with $ US3.5 million for hip fracture patients ( n = 255 ) . Mean incremental work loss costs per NV fracture employee were $ US1956 ( $ US4349 vs $ US2393 ; p < 0.05 ) . Among patients with available disability data , work loss accounted for 29.5 % of total costs per NV fracture employee . Conclusion : The cost burden of NV fracture patients to payers is substantial . Although hip fracture patients were more costly per patient in both Medicare and privately insured sample s , NVNH fracture patients still had substantial incremental costs . Because NVNH patients accounted for a larger proportion of the fracture population , they were associated with greater aggregate incremental healthcare costs than hip fracture patients
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 .