The PAADRN Study: A design for a randomized controlled practical clinical trial to improve bone health

Edmonds, Stephanie W.; Wolinsky, Fredric D.; Christensen, Alan J.; Lü, Xin; Jones, Michael P.; Roblin, Douglas W.; Cram, Peter

doi:10.1016/j.cct.2012.10.002

Cited by 23 publications

(40 citation statements)

References 51 publications

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“…The final brochure is available on request or can be found in publication. 7 Future publications will describe the effect that this brochure, with an accompanying personalized letter providing the DXA result, has on patients' health behaviors.…”

Section: Discussionmentioning

confidence: 99%

“…In concert with a large pragmatic trial, 7 the objective of this study was to report on our rigorous efforts to develop a bone health educational brochure that could be mailed to a broad audience of patients undergoing DXA in a typical testing center.…”

Section: Understanding Preferences For Osteoporosis Information To Dementioning

confidence: 99%

“…When searching for an osteoporosis educational brochure to use for a clinical trial (ClinicalTrials.gov NCT01507662), 7 we collected materials from leading bone health, women's health, and national health organizations for review. The Centers for Disease Control and Prevention (CDC) has created a guide for developing easy-to-understand health education materials.…”

Section: Introductionmentioning

confidence: 99%

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Understanding Preferences for Osteoporosis Information to Develop an Osteoporosis Patient Education Brochure

Edmonds

Solimeo

Nguyen

et al. 2017

TPJ

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Context: Patient education materials can provide important information related to osteoporosis prevention and treatment. However, available osteoporosis education materials fail to follow best-practice guidelines for patient education.Objective: To develop an educational brochure on bone health for adults aged 50 years and older using mixed-method, semistructured interviews.Design: This project consisted of 3 phases. In Phase 1, we developed written content that included information about osteoporosis. Additionally, we designed 2 graphic-rich brochures, Brochure A (photographs) and Brochure B (illustrations). In Phase 2, interviewers presented the text-only document and both brochure designs to 53 participants from an academic Medical Center in the Midwest and an outpatient clinic in the Southeastern region of the US. Interviewers used open-and closed-ended questions to elicit opinions regarding the brochures. In Phase 3, using feedback from Phase 2, we revised the brochure and presented it to 11 participants at a third site in the Southeastern US.Main Outcome Measures: Participants' comprehension of brochure text and acceptability of brochure design.Results: We enrolled 64 participants. Most were women, white, and college-educated, with an average age of 66.1 years. Participants were able to restate the basic content of the brochure and preferred Brochure A's use of photographs.Conclusions: Using feedback from older adults, we developed and refined a brochure for communicating bone health information to older adults at risk of osteoporosis and fragility fractures. The methods outlined in this article may serve to guide others in developing health educational brochures for chronic medical conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Understanding Preferences For Osteoporosis Information To Dementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Understanding Preferences for Osteoporosis Information to Develop an Osteoporosis Patient Education Brochure

Edmonds

Solimeo

Nguyen

et al. 2017

TPJ

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“…21 The PAADRN protocol was reviewed, approved, and monitored by the institutional review board of each of the three participating sites. In addition, the nurse consultation pilot RCT protocol was reviewed, approved, and monitored by the KPGA institutional review board.…”

Section: Study Setting and Populationmentioning

confidence: 99%

Evaluation of a “Just-in-Time” Nurse Consultation on Bone Health: A Pilot Randomized Controlled Trial

Roblin

Zelman

Plummer³

et al. 2017

TPJ

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Context: Evidence is inconclusive whether a nurse consultation can improve osteoporosis-related patient outcomes.Objective: To evaluate whether a nurse consultation immediately after dual-energy x-ray absorptiometry (DXA) produced better osteoporosis-related outcomes than a simple intervention to activate adults in good bone health practices or usual care.Design: Pilot randomized controlled trial, conducted within the larger Patient Activation After DXA Result Notification (PAADRN) trial (NCT01507662). After DXA, consenting adults age 50 years or older were randomly assigned to 3 groups: nurse consultation, PAADRN intervention (mailed letter with individualized fracture risk and an educational brochure), or usual care (control). Nurse consultation included reviewing DXA results, counseling on bone health, and ordering needed follow-up tests or physician referrals.Main Outcome Measures: Change from baseline to 52 weeks in participant-reported osteoporosis-related pharmacotherapy, lifestyle, activation and self-efficacy, and osteoporosis care satisfaction.Results: Nurse consultation participants (n = 104) reported 52-week improvements in strengthening and weight-bearing exercise (p = 0.09), calcium intake (p < 0.01), osteoporosis knowledge (p = 0.04), activation (p < 0.01), dietary self-efficacy (p = 0.06), and osteoporosis care satisfaction (p < 0.01). Compared with PAADRN intervention participants (n = 39), nurse consultation participants had improved dietary self-efficacy (p = 0.07) and osteoporosis care satisfaction (p = 0.05). No significant improvements in osteoporosis-related outcomes were achieved vs PAADRN controls (n = 70).Conclusion: "Just-in-time" nurse consultation yielded a few improvements over 52 weeks in osteoporosis-related outcomes; however, most changes were not different from those obtained through the lower-cost PAADRN intervention or usual care.

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“…13,14 Another potential solution has entailed creating processes whereby testing centers routinely provide test results directly to patients; such systems range from sending test results by mail to sophisticated Web-based electronic patient portals. 15 While there is growing momentum in favor of sharing test results with patients, few studies have empirically evaluated patients' preferences for receiving notification of their test results. [16][17][18] Moreover, we are unaware of any studies that have evaluated how preferences vary with patient demographics, the emotional impact of the particular test being considered, and whether the test result was normal or abnormal.…”

Section: Introductionmentioning

confidence: 99%

Patient Preferences for Test Result Notification

Shultz

Matelski

et al. 2015

J GEN INTERN MED

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IMPORTANCE:Patients are increasingly being given access to their test results, but little is known about how preferences vary with the test under consideration or the results of the test (normal or abnormal). OBJECTIVE: This study was conducted to examine preferences for test result communication. DESIGN, SETTING, AND PARTICIPANTS: We surveyed adults to explore their preferences for test result notification for three common diagnostic tests of varying "emotional impact" (dual-energy x-ray absorptiometry [DXA], genital herpes, and cancer biopsy) when test results were 1) normal and 2) abnormal. We conducted our survey between June and August 2012 on the campus of an academic medical center. For each scenario, subjects were asked to rank seven methods that might be used to communicate test results (letter, unsecured email, secured email, text message, telephone call, secure Web portal, office visit) in order of acceptability. MAIN OUTCOME MEASURES: The main measures were the percentage of respondents who ranked a particular test result notification method favorably and the percentage who ranked it as unacceptable. RESULTS: When test results were normal, subjects' notification preferences were generally similar for DXA, herpes and cancer biopsy, with telephone and letter ranked most favorably for all three tests. Conversely, text message and unsecured email were viewed as unacceptable notification methods for normal results by 45.0-55.0 % of subjects across all three tests. When test results were abnormal, office visits became more popular. A higher proportion of subjects ranked office visits as their most preferred notification method for our test with high "emotional impact" (cancer biopsy) (38.4 %) as compared to DXA (28.2 %) and herpes (27.9 %) (P=0.02). For most test scenarios, younger subjects appeared to rank electronic communication modalities (secure email or Web portal) higher than older subjects, though this difference did not reach statistical significance (P=0.29). CONCLUSIONS: Preferences for test result notification can differ substantially depending upon the test under consideration and results of the test. Providers and health care systems should consider these factors when deciding how to communicate results to patients.

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The PAADRN Study: A design for a randomized controlled practical clinical trial to improve bone health

Cited by 23 publications

References 51 publications

Understanding Preferences for Osteoporosis Information to Develop an Osteoporosis Patient Education Brochure

Understanding Preferences for Osteoporosis Information to Develop an Osteoporosis Patient Education Brochure

Evaluation of a “Just-in-Time” Nurse Consultation on Bone Health: A Pilot Randomized Controlled Trial

Patient Preferences for Test Result Notification

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