HipWatch: osteoporosis investigation and treatment after a hip fracture: a 6-month randomized controlled trial.
OBJECTIVE
We aimed to determine whether a novel Patient Empowerment and Physician Alerting (PEPA) intervention would improve the proportion of seniors who were investigated and treated for osteoporosis after hip fracture.


METHODS
We undertook a 6-month randomized controlled trial (RCT) in 48 women and men >/= 60 years old who had suffered a hip fracture and were admitted to a tertiary-care university hospital. The primary outcome measure was the proportion of participants offered one or more osteoporosis-specific 'best practices' measured using the Diagnosis and Management Questionnaire (DMQ). Participant responses were validated in part by physician report.


RESULTS
In the PEPA intervention group, 19 (68%) were offered one or more components of best practice care compared with 7 (35%) in the 'usual care' group (p <.05). In the PEPA group, 15 (54%) (p <.01) were prescribed bisphosphonate therapy, 8 (29%) (p <.01) had a bone mineral density scan, 11 (39%) were prescribed calcium and vitamin D (p =.32), and 9 (32%) (p <.01) were prescribed exercise. In the usual care group, 0 (0%) were prescribed bisphosphonate therapy, a bone mineral density assessment, or exercise and 6 (30%) were prescribed calcium and vitamin D.


CONCLUSIONS
This simple, inexpensive PEPA intervention resulted in far superior clinical management than did usual care in a population at high risk of future hip fracture.
Davis
Jennifer C
JC
University of British Columbia, Center for Hip Health, David Strangway Building, Suite 320-5950 University Boulevard, Vancouver, Canada V6T 1Z3.
Guy
Pierre
P
Ashe
Maureen C
MC
Liu-Ambrose
Teresa
T
Khan
Karim
K
D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001955:British Columbia / Q000453:epidemiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D010353:Patient Education as Topic; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D050071:Bone Density Conservation Agents