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 .
Physician treatment of osteoporosis in response to heel ultrasound bone mineral density reports.
Optimal information that should be included in ultrasound ( US ) heel bone mineral density ( BMD ) reports is not known . If additional information about further evaluation of patients with low heel BMD  were included in reports , would responses for treatment improve ? We screened people at health fairs using the Sahara heel US machine . For those with a T-score of < /= 1.0 , letters were sent to their primary care physician notifying them of the result . Physicians were r and omly assigned to ( 1 ) a st and ard letter , which recommended central bone density screening ( dual X-ray absorptiometry [ DXA ] ) and treatment if the BMD was low ; or ( 2 ) an extended letter , which also outlined treatment strategies based on recommended subsequent central DXA scan results for a T-score of < 1.50 and also if < 2.00 . The extended letter only increased the frequency of DXA testing from 30.1 to 37.2 % ( not a significant increase ) . Of 88 people with heel BMD < /= 1.00 and not previously on any treatment , 25 of 45 ( 56 % ) were treated ( calcium , estrogens , bisphosphonates , or calcitonin or a combination ) after physicians received a st and ard letter and 30 of 43 ( 70 % ) after an extended letter ( one-sided p = 0.084 ) . Of people with T < /= 1.9 , and initially taking nothing more than calcium , 5 of 36 ( 13.9 % ) received additional treatment after physicians received a st and ard letter vs 9 of 41 ( 22.0 % ) after an extended letter ( one-sided p = 0.180 ) . For those with T < /= 1.0 because of the screen 25 of 197 ( 12.7 % ) received additional treatment . One hundred forty-six of 194 ( 75 % ) individuals and received treatment with calcium or other medications , and 74 of 173 ( 43 % ) of individuals before screening and 141 of 195 ( 72 % ) after physicians received letters took calcium . Physicians regarded calcium alone as adequate treatment in many cases . There was no marked increase in treatment when additional information was provided to physicians regarding evaluation and treatment for low US heel BMD results
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 .