Improving Bone Health Among Rheumatoid Arthritis (RA) Patients on Chronic Glucocorticoids

Study Overview
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Brief Summary
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This quality improvement project is aimed at improving health care by identifying low cost strategies to get Rheumatoid Arthritis (RA) patients to more effectively communicate with their physicians about osteoporosis prevention and treatment (improving doctor-patient communication). The investigators will implement a direct to patient intervention to the population of interest (patients on chronic glucocorticoids) via story-telling, using an Internet based video. The target audience is people on chronic glucocorticoids not already receiving bones-specific osteoporosis medications to determine differences in post-intervention rates of osteoporosis care, and the rates of prescription anti-osteoporosis therapies.

Official Title
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Improving Bone Health Among RA Patients on Chronic Glucocorticoids

Conditions
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Osteoporosis, Adverse Effect of Glucocorticoids and Synthetic Analogues, Rheumatoid Arthritis

Intervention / Treatment
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* Other: Storytelling online video


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Greater than or equal to 5 milligrams of prednisone or glucocorticoid dose equivalent for greater than or equal to 90 days within the previous 12 months Medco member for entire study period Refill steroid prescription online Exclusion Criteria: anti-osteoporosis medication in previous 12 months

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Online video<br>Participants in this arm are shown a brief video ( 5 minutes) after ordering a refill for their glucocorticoid use. The video includes real patients telling their own story about the possible side effects of prolonged use of glucocorticoids. | Other: Storytelling online video<br>* patients with a history of chronic glucocorticoids use tell their experiences of side effects resulting from chronic use and provide advice on ways to prevent side effects<br>|
| No Intervention: No video<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants receiving Anti-osteoporosis Treatment | Includes bisphosphonates, PTH, SERM, Calcitonin | within 3 - 12 months of exposure to video | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Calcium and Vitamin D use | Are participants taking calcium and vitamin d supplements | within 3 - 12 months of exposure to video | 
| Patient-Physician Communication | Did viewing the video increase patient-physician communication | within 3 - 12 months of exposure to video |