Randomized Trial to Improve Fracture Prevention in Nursing Home Residents

Abstract

BACKGROUND-Interventions to improve the fracture prevention in nursing homes are needed.

Improving osteoporosis care through multimodal interventions: insights from the University of Alabama at Birmingham Center for Education and Research on Therapeutics

“…In light of this evidence and results from other studies[6, 7], we believe that evidence implementation needs to be a three-pronged approach involving not just the physician and healthcare providers, but also must consider the system and patient factors.…”

Do physicians within the same practice setting manage osteoporosis patients similarly? Implications for implementation research

“…To evaluate the effect on osteoporosis management of group practice setting and an individual physician's proclivity to treat his or her patients similarly, we used datasets from two separate randomized, controlled studies of osteoporosis quality improvement interventions(2, 3, 8, 9). The GIOP dataset included information for 6,281 long term glucocorticoid users enrolled in a large U.S. healthcare organization.…”

“…Using data from two previously published studies of osteoporosis management in long term glucocorticoid users (GIOP dataset) and nursing home patients with known osteoporosis or prior fracture (SPOF dataset) (2, 3, 8, 9), we evaluated whether there was significant similarity in osteoporosis management between physicians who practiced within the same outpatient group, or within the same nursing home. We tested the hypothesis that prior to any intervention and after controlling for patient factors (i.e.…”

Treatment of Osteoporosis in Australian Residential Aged Care Facilities: Update on Consensus Recommendations for Fracture Prevention

“…[27][28][29] Some of the potential causes for this treatment gap include limited access to diagnostic methods for fractures and BMD, lack of knowledge about evidence-based interventions for osteoporosis in RACFs, assumptions about length of stay and survival, and family and patients' concerns about polypharmacy and potential side effects. 8 Nevertheless, hip fractures in institutionalized older adults constitute an important cause of morbidity and mortality that could be prevented with an appropriate evidence-based approach to prevention.…”

“…A randomized trial to improve fracture prevention in nursing home residents demonstrated that audit feedback and education interventions are ineffective in improving fracture prevention. 28 In this study, nursing homes (n = 67) with >or = 10 residents with a diagnosis of osteoporosis or recent hip fracture (n = 606) were randomized to receive an early or delayed intervention consisting of audit and feedback, educational modules, teleconferences, and academic detailing. Medical record abstraction and the Minimum Data Set were used to measure the prescription of osteoporosis therapies before and after the intervention period, with no significant improvements being observed in any of the quality indicators.…”