Improving Treatment of Newly Diagnosed Osteoporosis

描述(由申请人提供)： 这项申请的目的是支持和促进彼得·克拉姆博士的职业发展，成为一名杰出的临床科学家和独立研究人员。在这份申请中，克拉姆博士组建了一支经验丰富的导师团队，其中包括珍妮特·施莱特博士(主要导师)、艾伦·克里斯滕森博士(联合导师)和罗伯特·华莱士博士(联合导师)，以确保他的成功发展。克拉姆博士的研究将重点放在骨质疏松症患者治疗的障碍上。为了实现他的目标，克拉姆博士将在导师的指导下，通过专注的教程和阅读材料，沉浸在严谨的学习中。他还将完成生物统计学和调查研究、健康心理学和研究伦理方面的有针对性的课程。此外，在Schlechte博士的指导下，他将获得骨质疏松症患者临床管理方面的专业知识。在资助期间，候选人将在三个不同的研究地点进行三个连续和递增的项目，以检查筛查双能X射线吸收测定(DXA)扫描被确认为骨质疏松症的患者的治疗障碍。项目1将涉及详细的病历审查，以确定与筛查DXA扫描后诊断为骨质疏松症患者的治疗不足相关的患者和医生特有的因素。项目2(从第18个月开始)将检查患者的偏好，以通知他们的结果以及社会人口和心理特征。项目3(从48个月开始)将以项目1和项目2的结果为基础。这项随机试验评估了患者激活干预，包括将他们的DXA扫描结果和关于他们结果解释的教育材料一起邮寄给患者，可以改善骨质疏松的治疗和患者的满意度。最后，这项工作将作为检查通过筛查确定的其他慢性病的障碍和改善治疗的模式。

DESCRIPTION (provided by applicant): The objective of this application is to support and foster the career development of Dr. Peter Cram in becoming an outstanding clinician-scientist and independent researcher. For this application, Dr. Cram has assembled a team of experienced mentors, Drs. Janet Schlecte (primary Mentor), Alan Christensen (Co-mentor), and Robert Wallace (Co-Mentor) to insure his successful development. Dr. Cram's research will focus on the barriers to treatment of patients with osteoporosis. In order to accomplish his goals, Dr. Cram will immerse himself in rigorous study through focused tutorials and readings guided by his mentors. He will also complete targeted coursework in areas of biostatistics and survey research, health psychology and ethical conduct of research. In addition, under the guidance of Dr. Schlechte, he will gain expertise in the clinical management of patients with osteoporosis. During the funding period, the candidate will conduct three sequential and incremental projects at three different study sites that examine barriers to treatment among patients who are identified as having osteoporosis on screening dual energy x-ray absorbtiometry (DXA) scan. Project 1 will involve a detailed medical record review to identify patient and physician-specific factors associated with undertreatment of patients diagnosed with osteoporosis after screening DXA scans. Project 2 (beginning in month 18) will examine patient preferences for notification of their results and socio-demographic and psychological traits. Project 3 (beginning in month 48) will be based upon the results of Projects 1 and 2. This randomized trial assess a patient activation intervention, consisting of mailing patients the results of their DXA scans along with education material about the interpretation of their results, can improve the treatment of osteoporosis and patient satisfaction. Finally, this work will serve as a model for examining the barriers to and improving treatment of other chronic diseases identified through screening.