The iCARE Study: Education Modules for Fracture Prevention
Condition: Osteoporosis; Frailty; Chronic Conditions, Multiple; Fracture
MeSH terms: Osteoporosis; Frailty; Chronic Disease; Multiple Chronic Conditions; Fractures, Bone
Study type: Observational

Summary: 
      A large proportion of older adults living in long term care homes are frail and have
      osteoporosis. With age, there is a gradual and progressive decline in bone quality and
      quantity and an increase in frailty, which is associated with increased fracture risk.
      Additionally, fractures pose a significant burden to the health and quality of life of long
      term care residents and contribute to high healthcare costs. Despite the high prevalence of
      osteoporosis, falls, and fractures in long term care, the management of osteoporosis is not
      optimal among long term care residents at risk of fracture. The aim of this study is to
      co-design a service provision (i.e., PREVENT - Person-centred Routine Fracture PreEVENTion)
      with healthcare providers in long term care and to determine the feasibility of implementing
      PREVENT in long term care settings.
    

Detailed description: 
      Fractures pose a significant burden on health, quality of life, and mortality of older adults
      in long term care (LTC) and contribute to high health care costs. PREVENT (Person-centred
      Routine Fracture PreEVENTion) is a scalable model for delivering routine assessments and
      interventions on diet and supplements, multifactorial fall and fracture prevention
      strategies, and medications to long term care teams to treat residents at high risk of
      fracture. The purpose of the iCARE study is to create a fall and fracture educational program
      (i.e., PREVENT) for LTC healthcare providers to deliver routine assessments for the
      management and treatment of osteoporosis. The benefit of such a guide may help to reduce the
      devastating impact of fractures in older adults residing in LTC homes. The aim of this pilot
      study is to: 1) determine feasibility and 2) adaptations through facilitators and barriers.
      Before a larger trial can be implemented to determine the effectiveness of the PREVENT
      Program in practice, the iCARE study seeks to determine the feasibility of implementing
      PREVENT in practice and identify strategies to tailor the program to the individual long term
      care home and care team through design thinking solutions.
    

Intervention name(s): PREVENT Program
Intervention type(s): Behavioral
Intervention description(s): PREVENT (Person-centred Routine Fracture PreEVENTion) is a scalable model for delivering routine assessments and interventions on diet and supplements, multifactorial fall and fracture prevention strategies, and medications to long term care teams to treat residents at high risk of fracture.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Care planning in long term care is a collaborative effort between the resident, the long
        term care healthcare provider, and the resident's family/caregiver. An internal champion
        will be identified to represent several long term care homes and who will help identify the
        five Professional Advisory Committees care teams who are the end-users of the PREVENT
        program. The Professional Advisory Committee may consist of a Director of Care/Nursing
        Director, Medical Director, Clinical Consultant Pharmacist, and other participating members
        who may include dietitians, rehabilitation staff, nurses, physicians, and personal support
        workers.
      
Keywords: Frailty; Service Provision; Education; Knowledge Translation; Knowledge Mobilization; Osteoporosis; Fracture Prevention; Long Term Care