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    Improving osteoporosis care in high-risk home health patients through a high-intensity intervention

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    Authors
    Outman, Ryan
    Curtis, Jeffrey R.
    Locher, Julie L.
    Allison, Jeroan J.
    Saag, Kenneth G.
    Kilgore, Meredith L.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2012-01-19
    Keywords
    Osteoporosis
    Home Care Services
    Biostatistics
    Epidemiology
    Health Services Research
    Musculoskeletal Diseases
    
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    Link to Full Text
    http://dx.doi.org/10.1016/j.cct.2011.09.020
    Abstract
    PURPOSE: We developed and tested a multi-modal intervention, delivered in the home health care setting, aimed at increasing osteoporosis treatment rates to prevent fractures. MATERIAL AND 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.
    Source
    Contemp Clin Trials. 2012 Jan;33(1):206-12. Epub 2011 Oct 8. doi: 10.1016/j.cct.2011.09.020
    DOI
    10.1016/j.cct.2011.09.020
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47885
    PubMed ID
    22005175
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.cct.2011.09.020
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    Population and Quantitative Health Sciences Publications

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