title: Evaluation of Patients' Response Toward Osteoporosis Letter Intervention Versus Phone Call Plus Letter Intervention.
abstract: BACKGROUND
  The aim of this study was to compare the effectiveness of 2 interventions in prompting patients to obtain osteoporosis follow-up after a fracture. Our hypothesis was that a phone call plus letter would yield greater response toward osteoporosis evaluation versus a letter alone to patients after sustaining a fragility fracture.
  
  
  METHODS
  Prospective study randomized 141 patients age 50 years and older with a fragility fracture into 3 groups for comparison. Group 1 (letter only) patients received a letter 3 months after their diagnosis of fracture indicating their risk for osteoporosis and urging them to follow-up for evaluation. Group 2 (phone call plus letter) patients were contacted via phone 3 months after their diagnosis of fracture. A letter followed the phone call. Group 3 (control) patients were neither contacted via phone nor sent a letter. All groups were contacted via phone 6 months after their initial visit to determine if they followed up for evaluation.
  
  
  RESULTS
  In group 1, 23 (52.27%) of 44 had follow-up, and 21 (47.73%) of 44 did not follow-up. In group 2, 30 (62.5%) of 48 had follow-up, and 18 (37.50%) of 48 did not follow-up. In group 3, 6 (12.24%) of 49 had some sort of follow-up, and 43 (87.76%) of 49 did not have any follow-up. A statistical significance was achieved between group 3 (control) and both groups 1 and 2 with regard to follow-up (P < .0001). The results did not show a statistically significant difference between Groups 1 and 2, however, there was a trend toward improved response with a phone call plus letter (P = .321).
  
  
  CONCLUSIONS
  A more personalized approach with a phone call plus follow-up letter to patients increased osteoporosis follow-up care by an additional 10%, however, this was not a statistically significant difference from just sending out a letter alone.
authors.affiliation: Department of Orthopedics, Medical Education, Pinnacle Health System, Harrisburg, PA, USA.
authors.forename: Lisa K
authors.initials: LK
authors.lastname: O'Brien
authors.affiliation: Penn State Milton S. Hershey Medical Center Bone and Joint Institute, Hershey, PA, USA.
authors.forename: April D
authors.initials: AD
authors.lastname: Armstrong
authors.affiliation: Penn State Milton S. Hershey Medical Center Bone and Joint Institute, Hershey, PA, USA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Hassenbein
authors.affiliation: Penn State Milton S. Hershey Medical Center Bone and Joint Institute, Hershey, PA, USA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Fox
keywords: economics of medicine; fragility fractures; geriatric medicine; geriatric trauma; osteoporosis; systems of care; trauma surgery