title: An educational intervention for providers to promote bone health in high-risk older patients.
abstract: OBJECTIVE
  To design, implement, and assess an educational intervention for providers focused on osteoporosis screening and management in older patients with chronic obstructive pulmonary disease or asthma who have been prescribed prolonged courses of oral or high-dose inhaled corticosteroids or both and are therefore at high risk for bone loss and fractures.
  
  
  METHODS
  One-group pretest-posttest.
  
  
  METHODS
  Academic outpatient pulmonary practice.
  
  
  METHODS
  Nineteen pulmonary specialists at an academic medical center.
  
  
  METHODS
  Educational theory and a needs assessment and attitude survey guided the development of a multicomponent educational intervention.
  
  
  METHODS
  Change in provider behavior was assessed by auditing the electronic medical records for adherence to osteoporosis management guidelines in high-risk patients seen by participants at baseline and for 6 months after the educational intervention. Knowledge transfer and changes in attitude were assessed using pre- and posttests and surveys.
  
  
  RESULTS
  A 19% increase in overall rate of adherence to osteoporosis management guidelines in high-risk patients was observed: 45% before intervention to 64% after intervention (n=249 patients, P=.003). Postintervention surveys and test scores also showed statistically significant gains from baseline.
  
  
  CONCLUSIONS
  An educational intervention improved adherence to osteoporosis management guidelines of academic pulmonary specialists. The results of this study provide evidence for the positive effect of a multimodal educational program in altering practice behaviors.
authors.affiliation: Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. msimone@mah.harvard.edu
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Simone
authors.forename: David H
authors.initials: DH
authors.lastname: Roberts
authors.forename: Julie T
authors.initials: JT
authors.lastname: Irish
authors.forename: Naama
authors.initials: N
authors.lastname: Neeman
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Schulze
authors.forename: Lewis A
authors.initials: LA
authors.lastname: Lipsitz
authors.forename: Richard
authors.initials: R
authors.lastname: Schwartzstein
authors.forename: Mark D
authors.initials: MD
authors.lastname: Aronson
authors.forename: Zaldy S
authors.initials: ZS
authors.lastname: Tan
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000517:prevention & control*; D010353:Patient Education as Topic; D012307:Risk Factors