compliance and medication adherence osteoporosis and decreased bone mineral density
Conditions
Interventions
None listed
Sponsors
Vrije Universiteit Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: population 1: -All patients 50 years of age or older, who have a clinical fracture and a low BMD defined as a T score * 2 population 2: -All patients 50 years of age or older, who have a clinical fracture and a BMD defined as a T score of * -1 and >-2 population 3: -All patients of 50 years or older, who have a clinical fracture and ar already being treated with anti-osteoporotic medication
Exclusion criteria
Exclusion criteria: -patients with a fracture after a traffic accident -patients with a pathological fracture -patients with fractures of hand, foot or scull -serious comorbidity or dementia -incapable of visiting the out patient clinic
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| I) 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%? II) 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-osteoporotic treatment after 1 year at 70% of those starting treatment? | — |
Secondary
| Measure | Time frame |
|---|---|
| III) are the data on subsequent fracture rates compatible with a reduction to 4%? IV) 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')? V) is the proportion of patients still on anti-osteoporotic treatment after 1 year significantly higher in the implementation group than in the control group? VI) what are the costs associated with the implementation of an osteoporosis nurse and how do these costs compare to the health benefits obtained. VII) what are the practical barriers encountered in trying to achieve the above mentioned goals? VIII) what are the practical barriers in the implementation of an osteoporosis nurse, and how can these be overcome? concerning population 2 and 3: 1. a) what proportion of patients without vertebral fractures and with a T score of * -1 and >-2, has sustained a new clinical fracture one year after the initial fracture? b) what proportion of patients already being treated with anti-osteoporotic medication, has sustained a new clinical fracture one year after the initial fracture? 2. is the proportion of patients still on anti-osteoporotic treatment after 1 year significantly different in the implementation group than in the group of patients who are being treated by another clinician or general practitioner? | — |
Countries
Netherlands
Outcome results
None listed