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dc.contributor.authorDanila, Maria I.
dc.contributor.authorAllison, Jeroan J.
dc.contributor.authorAnderson, Frederick A. Jr.
dc.contributor.authorWyman, Allison
dc.contributor.authorSaag, Kenneth G.
dc.date2022-08-11T08:09:50.000
dc.date.accessioned2022-08-23T16:45:20Z
dc.date.available2022-08-23T16:45:20Z
dc.date.issued2018-05-01
dc.date.submitted2018-07-06
dc.identifier.citation<p>J Bone Miner Res. 2018 May;33(5):763-772. doi: 10.1002/jbmr.3395. Epub 2018 Feb 26. <a href="https://doi.org/10.1002/jbmr.3395">Link to article on publisher's site</a></p>
dc.identifier.issn0884-0431 (Linking)
dc.identifier.doi10.1002/jbmr.3395
dc.identifier.pmid29377378
dc.identifier.urihttp://hdl.handle.net/20.500.14038/40662
dc.description<p>Full author list omitted for brevity. For the full list of authors, see article.</p>
dc.description.abstractOsteoporosis treatment rates are declining, even among those with past fractures. Novel, low-cost approaches are needed to improve osteoporosis care. We conducted a parallel group, controlled, randomized clinical trial evaluating a behavioral intervention for improving osteoporosis medication use. A total of 2684 women with self-reported fracture history after age 45 years not using osteoporosis therapy from US Global Longitudinal Study of Osteoporosis in Women (GLOW) sites were randomized 1:1 to receive a multimodal, tailored, direct-to-patient, video intervention versus usual care. The primary study outcome was self-report of osteoporosis medication use at 6 months. Other outcomes included calcium and vitamin D supplementation, bone mineral density (BMD) testing, readiness for behavioral change, and barriers to treatment. In intent-to-treat analyses, there were no significant differences between groups (intervention versus control) in osteoporosis medication use (11.7% versus 11.4%, p = 0.8), calcium supplementation (31.8% versus 32.6%, p = 0.7), vitamin D intake (41.3% versus 41.9%, p = 0.8), or BMD testing (61.8% versus 57.1%, p = 0.2). In the intervention group, fewer women were in the precontemplative stage of behavior change, more women reported seeing their primary care provider, had concerns regarding osteonecrosis of the jaw, and difficulty in taking/remembering to take osteoporosis medications. We found differences in BMD testing among the subgroup of women with no prior osteoporosis treatment, those who provided contact information, and those with no past BMD testing. In per protocol analyses, women with appreciable exposure to the online intervention (n = 257) were more likely to start nonbisphosphonates (odds ratio [OR] = 2.70; 95% confidence interval [CI] 1.26-5.79) compared with the usual care group. Although our intervention did not increase the use of osteoporosis therapy at 6 months, it increased nonbisphosphonate medication use and BMD testing in select subgroups, shifted participants' readiness for behavior change, and altered perceptions of barriers to osteoporosis treatment. Achieving changes in osteoporosis care using patient activation approaches alone is challenging. (c) 2018 American Society for Bone and Mineral Research.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=29377378&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016546/
dc.subjectBEHAVIORAL INTERVENTION
dc.subjectBISPHOSPHONATES
dc.subjectFRACTURE PREVENTION
dc.subjectNONBISPHOSPHONATES
dc.subjectOSTEOPOROSIS
dc.subjectBehavior and Behavior Mechanisms
dc.subjectHealth Psychology
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectMusculoskeletal Diseases
dc.subjectPharmaceutical Preparations
dc.subjectPublic Health Education and Promotion
dc.subjectTherapeutics
dc.subjectWomen's Health
dc.titleEvaluation of a Multimodal, Direct-to-Patient Educational Intervention Targeting Barriers to Osteoporosis Care: A Randomized Clinical Trial
dc.typeJournal Article
dc.source.journaltitleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
dc.source.volume33
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/oapubs/3464
dc.identifier.contextkey12450231
html.description.abstract<p>Osteoporosis treatment rates are declining, even among those with past fractures. Novel, low-cost approaches are needed to improve osteoporosis care. We conducted a parallel group, controlled, randomized clinical trial evaluating a behavioral intervention for improving osteoporosis medication use. A total of 2684 women with self-reported fracture history after age 45 years not using osteoporosis therapy from US Global Longitudinal Study of Osteoporosis in Women (GLOW) sites were randomized 1:1 to receive a multimodal, tailored, direct-to-patient, video intervention versus usual care. The primary study outcome was self-report of osteoporosis medication use at 6 months. Other outcomes included calcium and vitamin D supplementation, bone mineral density (BMD) testing, readiness for behavioral change, and barriers to treatment. In intent-to-treat analyses, there were no significant differences between groups (intervention versus control) in osteoporosis medication use (11.7% versus 11.4%, p = 0.8), calcium supplementation (31.8% versus 32.6%, p = 0.7), vitamin D intake (41.3% versus 41.9%, p = 0.8), or BMD testing (61.8% versus 57.1%, p = 0.2). In the intervention group, fewer women were in the precontemplative stage of behavior change, more women reported seeing their primary care provider, had concerns regarding osteonecrosis of the jaw, and difficulty in taking/remembering to take osteoporosis medications. We found differences in BMD testing among the subgroup of women with no prior osteoporosis treatment, those who provided contact information, and those with no past BMD testing. In per protocol analyses, women with appreciable exposure to the online intervention (n = 257) were more likely to start nonbisphosphonates (odds ratio [OR] = 2.70; 95% confidence interval [CI] 1.26-5.79) compared with the usual care group. Although our intervention did not increase the use of osteoporosis therapy at 6 months, it increased nonbisphosphonate medication use and BMD testing in select subgroups, shifted participants' readiness for behavior change, and altered perceptions of barriers to osteoporosis treatment. Achieving changes in osteoporosis care using patient activation approaches alone is challenging. (c) 2018 American Society for Bone and Mineral Research.</p>
dc.identifier.submissionpathoapubs/3464
dc.contributor.departmentDepartment of Surgery
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages763-772


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