Osteoporosis Coordinator for Low Volume Community Hospitals

NCT00511693 | Unknown

• 1 other identifier: TRI REB 07-029
• Study Type: interventional
• Target: 300
• Locations: 1 country
• Sites: 1

Brief Summary

A Regional Osteoporosis Coordinator located at Women's College Hospital will follow-up with low trauma fracture patients from 30 smaller community hospitals across Ontario. To evaluate whether this quality improvement program can increase post-fracture osteoporosis care in these individuals, hospitals will be randomized to receive osteoporosis specific recommendations or falls prevention advice. Patients will be asked to complete two short telephone surveys about their recent fracture, risk factors, osteoporosis knowledge and diagnostic and treatment history. All patients in the falls prevention advice group will receive the osteoporosis specific recommendations 6 months after their fracture.

Conditions

Osteoporosis; Fragility Fractures

Keywords

fragility fracture; management of osteoporosis; osteoporosis coordinator; small volume hospitals

Outcome Measures

Primary Outcomes (1)

• proportion of patients from the intervention group as compared to the control group that had "appropriate management" based on a composite of undergoing a BMD test and starting therapy within 6 months of fracture.

  1.5 years

Secondary Outcomes (2)

• osteoporosis knowledge, perceived susceptibility, self-efficacy, preventive behaviors

  1.5 years

• participants' experience and perceptions of future fracture risk; their understanding of the educational materials and acceptance of recommended treatment plans.

  1.5 years

Study Arms (2)

1

EXPERIMENTAL

hospitals randomly allocated to receive physician and patient osteoporosis recommendations from the regional coordinator

Behavioral: centralized osteoporosis coordinator

2

ACTIVE COMPARATOR

hospitals randomly allocated to receive falls prevention advice

Behavioral: fall prevention

Interventions

centralized osteoporosis coordinator BEHAVIORAL

The regional osteoporosis coordinator will phone fracture patients and counsel them about their risk of osteoporosis, reiterating messages in the print material. The coordinator will also follow-up with family physicians by phone and send them a patient-specific reminder that informs them that their patient has experienced a fracture and they are at high risk for future fracture. As part of the reminder, a set of evidence-based recommendations about appropriate BMD testing and treatment based on the recent Canadian guidelines will be included. If the patient does not have a family physician, the regional osteoporosis coordinator will facilitate referral to the MOP.

1

fall prevention BEHAVIORAL

Fracture patients from hospitals receiving falls prevention advice will also be called by the osteoporosis regional coordinator. The patient will receive educational material and telephone counseling regarding fall prevention. During the call, patients will be encouraged to visit their family physician for fracture follow-up. They will not receive counseling or educational materials about osteoporosis at this time. Patients in the falls prevention group will receive the physician and patient osteoporosis program six months post-fracture.

2

Eligibility Criteria

• Age: 40 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Cluster site (hospital) level: Hospitals with no dedicated osteoporosis coordinator that treat more than 60 patients/year in their Emergency Department and who have a Telehealth studio.
• Patient level: Patients 40 years old and over (men and women) presenting with a low trauma fracture of the hip, forearm and wrist, rib(s), sternum, thoracic and lumbar spine, shoulder and upper arm, pelvis, lower leg and ankle. Subjects without previous medication as well as subjects on osteoporosis medication and presenting with a fracture will be included.

You may not qualify if:

• Hospitals that have an Osteoporosis Strategy fracture clinic coordinator
• Fractures associated with major trauma; fractures due to malignancy

Sponsors & Collaborators

• Ontario Ministry of Health and Long Term Care: lead

Study Sites (1)

Toronto Rehabilitation Institute

Toronto, Ontario, M5G 2A2, Canada

RECRUITING

Related Publications (1)

• Jaglal SB, Donescu OS, Bansod V, Laprade J, Thorpe K, Hawker G, Majumdar SR, Meadows L, Cadarette SM, Papaioannou A, Kloseck M, Beaton D, Bogoch E, Zwarenstein M. Impact of a centralized osteoporosis coordinator on post-fracture osteoporosis management: a cluster randomized trial. Osteoporos Int. 2012 Jan;23(1):87-95. doi: 10.1007/s00198-011-1726-7. Epub 2011 Jul 16.

  PMID: 21779817 DERIVED

MeSH Terms

Conditions

Osteoporosis

Condition Hierarchy (Ancestors)

Bone Diseases, Metabolic; Bone Diseases; Musculoskeletal Diseases; Metabolic Diseases; Nutritional and Metabolic Diseases

Study Officials

• Susan B Jaglal PhD

  Toronto Rehabilitation Institute, University of Toronto

  PRINCIPAL INVESTIGATOR

• Oana S Donescu MD PhD

  Toronto Rehabilitation Institute, University of Toronto

  STUDY DIRECTOR

Central Study Contacts

Oana S Donescu, MD PhD

CONTACT

416 597-3422; Donescu.Smaranda@TorontoRehab.on.ca

Susan B Jaglal, PhD

CONTACT

416 978-0315; susan.jaglal@utoronto.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV

Study Record Dates

• First Submitted: August 3, 2007
• First Posted: August 6, 2007
• Study Start: June 1, 2007
• Study Completion: December 1, 2008
• Last Updated: August 7, 2007

Record last verified: 2007-07

Locations

CA (1)