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 .
Effect of a case-finding strategy for osteoporosis on bisphosphonate prescribing in primary care
Case- selection strategies have been advocated for identifying patients who would benefit from primary care to prevent osteoporosis . However , the effectiveness of this approach is unclear . To address this question , we performed a r and omized control trial to determine whether a case- selection strategy to identify patients with clinical risk factors for osteoporosis , combined with open access to dual X-ray absorptometry ( DXA ) scans  , influences bisphosphonate prescribing in ten GP practice s in Avon . Practice s were r and omized to two groups : the first identified women aged 45–75 years at high risk of osteoporosis and provided open access to DXA scans for 12 months ; the second had no case-finding strategy and no DXA scan access . Bisphosphonate prescribing was ascertained by search ing computerized patient records every 3 months during the intervention and a subsequent 6-month follow-up period . Overall , the number of subjects in each practice who were prescribed bisphosphonates  increased by 50 % ( p<0.001 ) , and the proportion of bisphosphonates prescribed as aminobisphosphonates  increased 3-fold ( p<0.001 ) . The magnitude of these changes was similar in both groups . However , of the patients prescribed bisphosphonates , approximately twice as many in group 1 , as compared with group 2 , had a previously documented low-trauma fracture , as assessed at the end of the 12-month intervention period ( p=0.01 ) . Furthermore , at study ’s end , of the 30 patients in group 1 receiving bisphosphonates who had received DXA scans , 80 % had osteoporosis as defined by t-score<-2.5 . We conclude that use of a case- selection strategy for osteoporosis in primary care , combined with open access to DXA scans , appears to target bisphosphonate therapy to those at high risk of osteoporotic fractures . In contrast , the overall rate of bisphosphonate prescribing is unaffected by this intervention
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 .