Electronic Medical Record Reminder Improves Osteoporosis Management After a Fracture: A Randomized, Controlled Trial

Abstract

Patient-specific postfracture advice to the provider through an EMR message significantly increased BMD measurement and osteoporosis medication. As EMRs become more widespread, this intervention could improve osteoporosis management for many postfracture patients. Future research should identify barriers to and facilitators of care for older, high-risk patients.

A review of lifestyle, smoking and other modifiable risk factors for osteoporotic fractures

“…The education approaches only had a significant impact on Ca and vitamin D supplement consumption. Few other studies have also assessed the utility of simple educational interventions on preventive behaviors for osteoporosis among women who sustained a fragility fracture, [84][85][86] all reached similar results. Another approach in the attempt to get patients to change the habits of the modifiable risk factors could be the use of risk assessment tools in communicating risk of osteoporosis or fracture.…”

Are physiotherapy guidelines for the management of osteoporosis being implemented? A UK-wide survey

“…Optimal strategies include the involvement of a local opinion leader, interaction between researchers and research users, reminders to care providers, and facilitating change through increased resources and training. [16][17] [28] [29] In the current study it was evident that some of the implementation strategies thought to be most effective were not used very often. This may be responsible for under-use of the guideline, as passive dissemination may not be sufficient to address barriers to guideline use.…”

Clinical Decision Support Tools for Osteoporosis Disease Management: A Systematic Review of Randomized Controlled Trials

“…Sources of methodological heterogeneity are shown in Tables 1 and 2. Reported study quality was generally poor-only four studies indicated all of sequence generation, concealment of randomization, blinding (Table 1) 31, [33][34][35] , the inclusion of at least 80% of patients in the analysis, and a description of reasons for dropouts/withdrawals (Table 2) 31, [33][34][35] . The follow-up period ranged between 2 and 28 months, and only four studies were analyzed according to ITT (Table 2) 31, 33,40,42 .…”

“…Authors were contacted to verify the accuracy of reporting of these criteria in their studies -we received verification from the authors of six studies (46%) 31,34,35,[40][41][42] . We decided not to use a quality assessment scale because evidence exists that they lack empirically supported components 27 , and authors of scales can be influenced by their own perception of study quality 28 .…”

“…Of these, 1,246 citations were screened for relevance, 42 articles were selected for full-text review, and 13 RCTs met the inclusion/exclusion criteria and were included in the systematic review [30][31][32][33][34][35][36][37][38][39][40][41][42] …”