title: Improving osteoporosis care in high-risk home health patients through a high-intensity intervention.
abstract: OBJECTIVE
  We developed and tested a multi-modal intervention, delivered in the home health care setting, aimed at increasing osteoporosis treatment rates to prevent fractures.
  
  
  METHODS
  The intervention focused on home health nurses. Key components included: nursing education; development of a nursing care plan; patient teaching materials and creation of physician materials. Nursing education consisted of a lecture covering osteoporosis, fracture risks and prevention, and the effectiveness of anti-osteoporosis treatment options. Patients received education materials concerning osteoporosis and anti-osteoporosis medications. A pocket-sized treatment algorithm card and standardized order sets were prepared for physicians. Focus groups of physicians and nurses were conducted to obtain feedback on the materials and methods to facilitate effective nurse-physician communication. Successful application required nurses to identify patients with a fracture history, initiate the care plan, prompt physicians on risk status, and provide patient education. The intervention was piloted in one field office.
  
  
  RESULTS
  In the year prior to the intervention, home health patients (n=92) with a fracture history were identified in the pilot field office and only 20 (22%) received osteoporosis prescription therapy. In the three months following the intervention, 21 newly enrolled patients were identified and 9 (43%) had received osteoporosis prescription medications.
  
  
  CONCLUSIONS
  Home health care provides a venue where patients and physicians can be informed by nurses about osteoporosis and fracture risks and, consequently, initiate appropriate therapy. This multi-modal intervention is easily transportable to other home health agencies and adaptable to other medical conditions and settings.
authors: Department of Medicine, Division of Immunology and Rheumatology, University of Alabama at Birmingham, FOT 820, 1530 3rd Ave S, Birmingham, AL 35294, United States. routman@uab.edu
authors: Ryan C
authors: RC
authors: Outman
authors: Jeffrey R
authors: JR
authors: Curtis
authors: Julie L
authors: JL
authors: Locher
authors: Jeroan J
authors: JJ
authors: Allison
authors: Kenneth G
authors: KG
authors: Saag
authors: Meredith L
authors: ML
authors: Kilgore
mesh_terms: D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D017144:Focus Groups; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000628:therapy*; D010353:Patient Education as Topic; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents