title: Pop-up messages in order communication systems can increase awareness of osteoporosis among physicians and improve osteoporosis treatment.
abstract: OBJECTIVE
  The purpose of this study was to verify the effect of pop-up messages (regarding a history of dual-energy X-ray absorptiometry [DXA]) on the identification and management of osteoporosis after osteoporotic hip or spine fractures. We hypothesized that these pop-up messages would increase the awareness and management of osteoporosis among clinicians and patients.
  
  
  METHODS
  We introduced pop-up messages regarding a history of DXA in our Order Communication System (March 2012) and evaluated the records of 404 patients who were treated between January 2011 and December 2012. The patients were categorized as being treated without the pop-up messages (Group I, before March 2012) or with the pop-up messages (Group II, after March 2012). We compared their rates of DXA prescription, osteoporosis medication, exercise, mortality and subsequent refractures during a 2-year follow-up.
  
  
  RESULTS
  After introducing the pop-up messages, the DXA prescription rate increased from 35.1 to 57.1% (P < 0.001), the osteoporosis medication rate increased from 21.1 to 25.2% (P = 0.05) and the exercise rate increased from 35.6 to 40.5% (P = 0.018). During the 2-year follow-up, the mortality rates were 4.64% in Group I and 6.67% in Group II (P = 0.4). Subsequent refractures were found in 12.9% of Group I patients and 9.52% of Group II patients (P = 0.87).
  
  
  CONCLUSIONS
  The pop-up messages positively affected the behaviours of orthopaedic surgeons and were associated with increased rates of prescription of DXA, osteoporosis medication, and might affect the behaviour of patient, increased exercise rate. Therefore, we recommend using this simple and effective method to improve physicians' awareness of osteoporosis.
authors.affiliation: Department of Orthopedic Surgery, Myongji Hospital, Seonam University College of Medicine, Goyang-si, Korea.
authors.forename: Joon Yub
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Myongji Hospital, Seonam University College of Medicine, Goyang-si, Korea.
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Yoo
authors.affiliation: Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Ji Wan
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Myongji Hospital, Seonam University College of Medicine, Goyang-si, Korea.
authors.forename: Gwang Young
authors.initials: GY
authors.lastname: Sung
authors.affiliation: Department of Orthopedic Surgery, Myongji Hospital, Seonam University College of Medicine, Goyang-si, Korea.
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: Jung
authors.affiliation: Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Yohan
authors.initials: Y
authors.lastname: Cho
authors.affiliation: Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
authors.forename: Jai Hyung
authors.initials: JH
authors.lastname: Park
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000554:Ambulatory Care Facilities; D001364:Awareness; D003142:Communication; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy; D058866:Osteoporotic Fractures / Q000517:prevention & control; D056910:Republic of Korea; D012189:Retrospective Studies; D012984:Software; D016103:Spinal Fractures / Q000517:prevention & control
keywords: order communication systems; osteoporosis; pop-up messages