Journal
OSTEOPOROSIS INTERNATIONAL
Volume 20, Issue 2, Pages 265-274Publisher
SPRINGER LONDON LTD
DOI: 10.1007/s00198-008-0654-7
Keywords
Educational outreach; Fragility fracture; Intervention; Rural; Osteoporosis
Categories
Funding
- Primary Health Care Transition Fund [G03-02596]
- Toronto Rehabilitation Institute/ University of Toronto Chair in Rehabilitation Research
- Canadian Institutes of Health Research Scientist
- Academic Women's Medicine at the University of Toronto
- Chair in Orthopaedic Clinical Epidemiology at Sunnybrook Health Sciences Centre
- University of Toronto
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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.
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