osteoporosis (osteoporose, botontkalking) fracture (fractuur, botbreuk) implementation (implementatie) nurse-practitioner (fractuur verpleegkundige)
Conditions
Interventions
In the implementation group the patients will be screened for osteoporosis by DXA measurement, and a spine X ray will be performed. At baseline and after 12 months a blood sample will be taken. At bas
Sponsors
VUmc
Eligibility
Inclusion criteria
Inclusion criteria: All patients 50 years of age or older, who have a clinical fracture and a low BMD defined as a T score smaller or equal 2.
Exclusion criteria
Exclusion criteria: 1. Patients with a fracture after a traffic accident 2. Patients with a pathological fracture 3. Patients with fractures of hand, foot or scull 4. Serious comorbidity or dementia 5. Incapable of visiting the out patient clinic
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Is it possible to improve routine detection and treatment of osteoporosis after an initial fracture? 1.Is it possible to increase the proportion of patients adequately screened and categorized as to the presence of osteoporosis from current practice of 5-40% to at least 70%? 2. In patients found to have osteoporosis, is it possible to: a. start treatment in nearly all applicable patients? b. maintain the proportion of patients still on anti osteoporotis treatment after 1 year at 70% of those starting treatment? | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Are the data on subsequent fracture rates compatible with a reduction to 4%? 2. Is the proportion of patients screened for osteoporosis with a DXA measurement significantly higher in the implementation group (with fracture nurse) than in the control group (without a fracture nurse; 'usual care')? 3. Is the proportion of patients still on anti osteoporosis treatment after 1 year significantly higher in the implementation group than in the control group? 4. What are the costs associated with the implementation of an osteoporosis nurse and how do these costs compare to the health benefits obtained. 5. What are the practical barriers encountered in trying to achieve the above mentioned goals? 6. What are the practical barriers in the implementation of an osteoporosis nurse, and how can these be overcome? | — |
Contacts
Public ContactDA Eekman
VU Medical Center depatment of rheumatology 4a-42 Boelelaan 1117
Outcome results
None listed