A demonstration project of a multi-component educational intervention to improve integrated post-fracture osteoporosis care in five rural communities in Ontario, Canada

被引：29

作者：

Jaglal, S. B. ^{[1
,9
]}

Hawker, G. ^{[1
,2
]}

Bansod, V. ^{[1
]}

Salbach, N. M. ^{[9
]}

Zwarenstein, M. ^{[3
]}

Carroll, J. ^{[4
,5
]}

Brooks, D. ^{[9
]}

Cameron, C. ^{[1
]}

Bogoch, E. ^{[6
,7
]}

Jaakkimainen, L. ^{[5
]}

Kreder, H. ^{[7
,8
]}

机构：

[1] Womens Coll Hosp, Osteoporosis Res Program, Toronto, ON M5S 1B2, Canada

[2] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON M5G 1V7, Canada

[3] Inst Clin Evaluat Sci, Toronto, ON, Canada

[4] Mt Sinai Hosp, Dept Family Med, Toronto, ON M5G 1X5, Canada

[5] Univ Toronto, Dept Community & Family Med, Toronto, ON M5G 1V7, Canada

[6] St Michaels Hosp, Mobil Program, Toronto, ON M5B 1W8, Canada

[7] Univ Toronto, Dept Surg, Toronto, ON M5G 1V7, Canada

[8] Sunnybrook Hlth Sci Ctr, Orthopaed & Arthrit Inst, Toronto, ON M4N 3M5, Canada

[9] Univ Toronto, Dept Phys Therapy, Toronto, ON M5G 1V7, Canada

来源：

OSTEOPOROSIS INTERNATIONAL | 2009年 / 20卷 / 02期

基金：

加拿大健康研究院;

关键词：

Educational outreach; Fragility fracture; Intervention; Rural; Osteoporosis; RANDOMIZED CONTROLLED-TRIAL; EVIDENCE-BASED MEDICINE; FRAGILITY FRACTURE; DISEASE-MANAGEMENT; RHEUMATIC-DISEASES; WRIST FRACTURE; SYSTEM LEVELS; HIP FRACTURE; DIAGNOSIS; PROGRAM;

D O I：

10.1007/s00198-008-0654-7

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

This study evaluated a multi-component intervention (educational materials and outreach visits) to increase knowledge and improve post-fracture care management in five rural communities in Canada. One hundred and twenty-five patients pre- intervention and 149 post-intervention were compared. No significant improvement in post-fracture care was documented suggesting that a more targeted intervention is needed. Currently, the majority of patients with a low trauma fracture are under-investigated and under-treated for osteoporosis. We set out to evaluate an educational intervention on increasing knowledge of post-fracture care among health care professionals (HCPs) and fracture patients and on improving post-fracture management. We studied five rural communities in Ontario, Canada, using a multi-component intervention ("Behind the Break"), including educational material for HCPs and patients and educational outreach visits to physicians. The study had a historical control, non-equivalent pre/post design. Telephone surveys were carried out with individuals a parts per thousand yen40 years of age who had a low trauma fracture in 2003 (n = 125) or in 2005 (n = 149). Family physicians and emergency department staff were also surveyed. A total of 4,207 educational packages were distributed. Seventy-three percent of family physicians had an outreach visit. Two-thirds indicated that they received enough information about post-fracture follow-up to incorporate it into their practice. Despite this, no significant improvement in post-fracture care was documented (32% in the "pre" group had a bone mineral density test and 25% in the "post" group). Of those diagnosed with osteoporosis, the majority were prescribed a bone-sparing medication (63% "pre" and 80% "post"). A more targeted intervention linking fracture patients to their physician needs to be evaluated in rural communities.

引用

页码：265 / 274

页数：10

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