Patients’ Response Toward an Automated Orthopedic Osteoporosis Intervention Program

Abstract

Osteoporosis is overshadowed in an era of chronic illnesses, and a care gap exists between physicians and patients. The aim of this study was to determine the effectiveness of implementing an automated system for identifying and sending a letter to patients at high risk for osteoporosis. Patients 50 years of age and older were tagged with an International Classification of Diseases, Ninth Revision, diagnostic code upon initial visit to the emergency department (ED), identifying potential fragility fractures. Automatically generated letters were sent via our osteoporosis database system to each patient 3 months after the initial visit to the ED. The letter indicated that he or she was at risk for osteoporosis and suggested that the patient schedule a follow-up appointment with a physician. Patients were subsequently telephoned 3 months after receiving the letter and asked about their current plan for follow-up. The control group did not receive a letter after departure from the ED. In the control group, 84 (85.71%) individuals of the total 98 did not have any follow-up but the remaining 14 (14.29%) sought a follow-up. In the intervention group, 62 (60.19%) individuals of 103 did schedule a follow-up, while the remaining 41 (39.81%) did not seek a follow-up. Thus, the patient follow-up response rate after fracture treatment improved with intervention (P < .0001). Current literature has demonstrated the low rate of follow-up care addressing osteoporosis in patients experiencing fragility fractures (1%-25% without intervention). Research has shown the effectiveness of various types of intervention programs for improving the continuum of care for these high-risk patients. Nonautomated intervention programs can have a multitude of human-related system failures in identifying these patients. Our study successfully implements an automated system that is able to be applied to most hospitals with minimal cost and resources.

Evaluation of Patients’ Response Toward Osteoporosis Letter Intervention Versus Phone Call Plus Letter Intervention

“…Multiple studies have shown efficacy in simply sending out standardized letters to patients at risk. 14 , 20 , 28 Our previous study showed success with a simple automated letter. 14 Methods that lack automation may be too time consuming and cumbersome, and patient identification for program inclusion is at greater risk of being overlooked secondary to human error.…”

“…A wide variety of intervention programs has demonstrated effectiveness in improving the continuum of care, with the rate of patient follow-up significantly greater with an intervention program in place compared to no program. 8,10,14,16,20 –26…”

“…For example, our prior study showed a 60% response rate compared to 15% without any intervention ( P < .0001). 14 …”

Efficacy of four hollow nail rhombic fixation for the treatment of patients with femoral neck fractures: A protocol of systematic review and meta-analysis

“…Femoral neck fractures (FNF) is a common injury in the emergency visits, especially in elderly population [1][2][3]. It is estimated that the incidence of hip factures is approximately 6 million by 2050 worldwide [4][5], and FNF accounts for about 50% of all hip fractures [6][7]. It is associated with impaired mobility, loss of function, mortality and morbidity [8][9][10][11].…”

Association between MRI findings and back pain after osteoporotic vertebral fractures: a multicenter prospective cohort study

“…Osteoporosis is a condition in which there is compromised bone strength due to deterioration in bone mass and quality.It is predominantly seen in the elderly, with 10 million individuals currently diagnosed with osteoporosis in the United States [1][2][3][4]. It is estimated that more than three times as many individuals have low bone mass and are at risk for the disease [5].Although the occurrence is often not recognized as a distinct clinical event, fractures can result in acute or chronic pain, height loss, spinal deformity (kyphosis, scoliosis), and restriction of thoracic and abdominal contents, impaired mobility and disability.…”