The utilization of appropriate osteoporosis medications improves following a multifaceted educational intervention: the Canadian quality circle project (CQC).
BACKGROUND
Osteoporosis is a serious but treatable condition. However, appropriate therapy utilization of the disease remains suboptimal. Thus, the objective of the study was to change physicians' therapy administration behavior in accordance with the Osteoporosis Canada 2002 guidelines.


METHODS
The Project was a two year cohort study that consisted of five Quality Circle (QC) phases that included: 1) Training & Baseline Data Collection, 2) First Educational Intervention & First Follow-Up Data Collection 3) First Strategy Implementation Session, 4) Final Educational Intervention & Final Follow-up Data Collection, and 5) Final Strategy Implementation Session. A total of 340 family physicians formed 34 QCs and participated in the study. Physicians evaluated a total of 8376, 7354 and 3673 randomly selected patient charts at baseline, follow-up #1 and the final follow-up, respectively. Patients were divided into three groups; the high-risk, low-risk, and low-risk without fracture groups. The generalized estimating equations technique was utilized to model the change over time of whether physicians


RESULTS
The odds of appropriate therapy was 1.29 (95% CI: 1.13, 1.46), and 1.41 (95% CI: 1.20, 1.66) in the high risk group, 1.15 (95% CI: 0.97, 1.36), and 1.16 (95% CI: 0.93, 1.44) in the low risk group, and 1.20 (95% CI: 1.01, 1.43), and 1.23 (95% CI: 0.97, 1.55) in the low risk group without fractures at follow-up #1 and the final follow-up, respectively.


CONCLUSIONS
QCs methodology was successful in increasing physicians' appropriate use of osteoporosis medications in accordance with Osteoporosis Canada guidelines.
Ioannidis
George
G
Department of Medicine, McMaster University, Hamilton, Canada. g.ioannidis@sympatico.ca.
Papaioannou
Alexandra
A
Thabane
Lehana
L
Gafni
Amiram
A
Hodsman
Anthony
A
Kvern
Brent
B
Walsh
Aleksandra
A
Jiwa
Famida
F
Adachi
Jonathan D
JD
D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002170:Canada; D015331:Cohort Studies; D016001:Confidence Intervals; D004521:Educational Measurement; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D010024:Osteoporosis / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D016730:Program Development; D015397:Program Evaluation; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000592:standards*
D050071:Bone Density Conservation Agents