Osteoporosis, Management Care, Fracture
Conditions
Brief summary
Harrington's metaphorical depiction captures the essence of the problem : Osteoporosis care of fracture patients has been characterized as the Bermuda Triangle made up of orthopaedists, primary care physicians and osteoporosis experts into which the fracture patient disappears. The most effective way to achieve this goal is through implementation of coordinator-based post fracture models of care. Exemplar models have been refered to as Fracture Liaison Service (United-Kingdom \[1-3\], Europe \[4,5\] and Australia \[6-8\]) Osteoporosis Coordinator Program (Canada \[9,10\]) or Care Manager Programs (USA \[11,12\]). The objective of this trial is to assess efficacy of a new coordinator-based post-fracture program in the Saint-Joseph Hospital in Paris to improve the management of osteoporosis after fracture thanks to an optimal recommendations practice to reduce the incidence of secondary fractures. Men and women are included aged over 45 years with fragility wrist and hip fractures. Evaluation criteria are based on the evidence-based assessment (stratify risk, identify secondary causes of osteoporosis, fracture evaluation), the medication adherence, others prescriptions adherence (osteodensitometry), the incidence of secondary fractures and number of falls. Number of patients : 200 Duration of the study: 3 years Patients' participation duration: 6 months
Interventions
BEHAVIORALCoordinator-based post fracture program
Sponsors
Assistance Publique - Hôpitaux de Paris
Fondation Hôpital Saint-Joseph
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
45 Years to 95 Years
Healthy volunteers
No
Inclusion criteria
* Men and women over 45 years * Fragility wrist and hip fractures * Volunteer
Exclusion criteria
* Public route accident * Emergency illness associated * Short life expectancy * Not volunteer * Bedridden patient
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of patient with a correct management care. | 6 months | This outcome is a composite outcome wich differ with each fracture type. It will be assess 6 months after patient inclusion. An adequate management care is defined for each fracture as below. * For wrist fracture: medical visit at J15, osteodensitometry, therapeutic decision if necessary (if not, reasons have to be precised in medical sheet). * For hip fracture: osteodensitometry if necessary, therapeutic (chronic care) decision if necessary (if not, reasons have to be precised in medical sheet). |
Secondary
| Measure | Time frame |
|---|---|
| Patient adherence to their osteoporosis medication (Morisky composite score) and exploration (osteodensitometry). | 6 months |
Other
| Measure | Time frame |
|---|---|
| Number of rehospitalisation for fracture. | 6 months |
| Number of falls over 6 months post-inclusion. | 6 months |
Countries
France
Outcome results
None listed