title: Improving care of patients at-risk for osteoporosis: a randomized controlled trial.
abstract: BACKGROUND
  Despite accurate diagnostic tests and effective therapies, the management of osteoporosis has been observed to be suboptimal in many settings. We tested the effectiveness of an intervention to improve care in patients at-risk of osteoporosis.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Primary care physicians and their patients at-risk of osteoporosis, including women 65 years and over, men and women 45 and over with a prior fracture, and men and women 45 and over who recently used > or =90 days of oral glucocorticoids.
  
  
  METHODS
  A multifaceted program of education and reminders delivered to primary care physicians as well as mailings and automated telephone calls to patients.
  
  
  RESULTS
  Either undergoing a bone mineral density (BMD) testing or filling a prescription for a bone-active medication during the 10 months of follow-up.
  
  
  RESULTS
  After the intervention, 144 (14%) patients in the intervention group and 97 (10%) patients in the control group received either a BMD test or filled a prescription for an osteoporosis medication. This represents a 4% absolute increase and a 45% relative increase (95% confidence interval 9-93%, p = 0.01) in osteoporosis management between the intervention and control groups. No differences between groups were observed in the incidence of fracture.
  
  
  CONCLUSIONS
  An intervention targeting primary care physicians and their at-risk patients increased the frequency of BMD testing and/or filling prescriptions for osteoporosis medications. However, the absolute percentage of at-risk patients receiving osteoporosis management remained low.
authors.affiliation: Division of Pharmacepidemiology, Brigham and Women's Hospital, Boston, MA 02120, USA. dhsolomon@partners.org
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Solomon
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Polinski
authors.forename: Margaret
authors.initials: M
authors.lastname: Stedman
authors.forename: Colleen
authors.initials: C
authors.lastname: Truppo
authors.forename: Laura
authors.initials: L
authors.lastname: Breiner
authors.forename: Catherine
authors.initials: C
authors.lastname: Egan
authors.forename: Saira
authors.initials: S
authors.lastname: Jan
authors.forename: Minal
authors.initials: M
authors.lastname: Patel
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Weiss
authors.forename: Ya-ting
authors.initials: YT
authors.lastname: Chen
authors.forename: M Alan
authors.initials: MA
authors.lastname: Brookhart
mesh_terms: D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005791:Patient Care / Q000379:methods*; D010821:Physicians, Family; D012307:Risk Factors