Improving osteoporosis screening: results from a randomized cluster trial.
Improving osteoporosis screening: results from a randomized cluster trial.
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DOI：
10.1007/s11606-006-0060-9
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发表时间：
2007-03
影响因子：
5.7
通讯作者：
Muma, Bruce K.
中科院分区：
文献类型：
--
作者：
Lafata, Jennifer Elston;Kolk, Deneil;Peterson, Edward L.;McCarthy, Bruce D.;Weiss, Thomas W.;Chen, Yo-Ting;Muma, Bruce K.
尽管有建议，65岁及以上妇女的骨质疏松症筛查率仍然很低。我们目前的结果，从一个集群，随机试验评估病人邮寄提醒，单独和结合医生的提示，以改善骨质疏松症的筛查和治疗。初级保健诊所（n = 15）被随机分配到常规护理，单独邮寄提醒，或邮寄提醒与医生提示。研究患者为65-89岁的女性（N = 10，354）。使用自动化的临床和药房数据，收集骨密度检测、药房配药和其他患者特征的信息。使用广义估计方程法评估了检测和治疗中未校正/校正的差异。骨质疏松症筛查率在常规护理中为10.8%，在邮寄提醒中为24.1%，在医生提示下邮寄提醒中为28.9%。基线差异调整的结果表明，邮寄提醒显着提高检测率相比，通常的护理，并提示进一步提高测试。这种影响随着患者年龄的增长而增加。常规护理的治疗率为5.2%，邮寄提醒的治疗率为8.4%，邮寄提醒的治疗率为9.1%。在单独接受邮件提醒或结合医生提示的患者之间，治疗率没有显著差异。然而，接受常规护理的妇女接受治疗的可能性明显降低。单独或在医生提示下使用邮寄提醒可以显着提高投保初级保健患者的骨质疏松症筛查和治疗率（Clinical Trials.gov编号NCT 00139425）。
Despite recommendations, osteoporosis screening rates among women aged 65 years and older remain low. We present results from a clustered, randomized trial evaluating patient mailed reminders, alone and in combination with physician prompts, to improve osteoporosis screening and treatment. Primary care clinics (n = 15) were randomized to usual care, mailed reminders alone, or mailed reminders with physician prompts. Study patients were females aged 65–89 years (N = 10,354). Using automated clinical and pharmacy data, information was collected on bone mineral density testing, pharmacy dispensings, and other patient characteristics. Unadjusted/adjusted differences in testing and treatment were assessed using generalized estimating equation approaches. Osteoporosis screening rates were 10.8% in usual care, 24.1% in mailed reminder, and 28.9% in mailed reminder with physician prompt. Results adjusted for differences at baseline indicated that mailed reminders significantly improved testing rates compared to usual care, and that the addition of prompts further improved testing. This effect increased with patient age. Treatment rates were 5.2% in usual care, 8.4% in mailed reminders, and 9.1% in mailed reminders with prompt. No significant differences were found in treatment rates between those receiving mailed reminders alone or in combination with physician prompts. However, women receiving usual care were significantly less likely to be treated. The use of mailed reminders, either alone or with physician prompts, can significantly improve osteoporosis screening and treatment rates among insured primary care patients (Clinical Trials.gov number NCT00139425).
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影响因子：
7.2
作者：
Silverman, SL;Greenwald, M;Drinkwater, BL
通讯作者：
Drinkwater, BL
DOI：
10.2106/00004623-200312000-00005
发表时间：
2003-12-01
影响因子：
5.3
作者：
Feldstein, AC;Nichols, GA;Herson, M
通讯作者：
Herson, M
影响因子：
10.3
作者：
Church, TR;Yeazel, MW;Engelhard, D
通讯作者：
Engelhard, D
影响因子：
--
作者：
Balas, EA;Weingarten, S;Brown, GD
通讯作者：
Brown, GD
影响因子：
5.1
作者：
Schmittdiel, J;McMenamin, SB;Casalino, LP
通讯作者：
Casalino, LP