Adoption of osteoporosis screening in older women

对老年女性进行骨质疏松症筛查

基本信息

批准号：
7277669
负责人：
JOAN Marie NEUNER
金额：
$ 12.64万
依托单位：
MEDICAL COLLEGE OF WISCONSIN
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-09-30 至 2009-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7277669
关键词：
Address Adoption Advisory Committees Advocate Age Age Factors Aging Award Behavior Bone Density Caring Characteristics Cholesterol Clinical Clinical Trials Data Data Set Development Diagnosis Disease Elderly Ensure Epidemic Foundations Fracture Fright Future Goals Guidelines Health behavior Hip Fractures Influenza vaccination Intervention Investigation Lead Link Mammography Measures Mediating Medicare Mentors Methodology Morbidity - disease rate Osteoporosis Patient Care Patients Pattern Perception Physicians Population Postmenopause Prevention Preventive Primary Care Physician Primary Health Care Provider Publishing Rate Recommendation Recording of previous events Relative (related person)Reporting Research Research Personnel Resources Risk Risk Factors Screening procedure Services Socioeconomic Factors Socioeconomic Status Sum Survey Methodology Surveys Testing Time Translating United States Woman aged career health literacy improved medical specialties older patient older women osteoporosis with pathological fracture prevent programs research and development skills

项目摘要

DESCRIPTION (provided by applicant): At least 40% of postmenopausal women in the United States will suffer an osteoporotic fracture, yet little is known about current physician and patient practices in bone mineral density screening to identify patients at high fracture risk. This proposal describes an integrated, mentored program of career development and research that will lead to the applicant's development into an independent investigator in prevention of fractures in aging patients. The central career development goal of this proposal is to gain skills in both analysis of screening patterns in large national administrative datasets and in survey methodology through an investigation of patterns in and barriers to the adoption of osteoporosis screening. In sum, at the end of this award, I will have gained skills in sophisticated analyses of national patterns in preventive behaviors, methodology for measuring risk perceptions and health literacy, and survey research. Osteoporotic fractures are very common and cause great morbidity, there are proven interventions to prevent fractures, and guidelines advocating screening have been published. Despite this, evidence from other preventive care suggests adoption of osteoporosis screening will be slow and have unexpected influences. This adoption can be accelerated if current patterns in and barriers to care of osteoporosis are understood. To develop this understanding we aim to 1) Develop a methodology for using Medicare administrative claims data to assess rates of bone mineral density (BMD) testing 2) Examine the adoption of BMD with respect to patient characteristics 3) Examine the use of bone density testing among panels of patients cared for by primary care physicians, 4) Determine the relative contribution of patient and physician factors to adoption of BMD, and 5) Use survey methodology to further explore disparities by factors such as age and SES found in the initial analyses. We will examine Medicare data from women in three states in 1998-2002 linked with physician information from the AMA to examine aims 1-4. We then will survey primary care patients to evaluate the effect of risk perceptions, health literacy and numeracy, and other barriers on patient disparities in screening. It is important that we identify patients at greatest risk for lack of osteoporosis screening, the providers who employ it least, and patient reports of barriers to screening to improve future osteoporosis care.

描述（由申请人提供）：美国至少有40％的绝经后妇女将遭受骨质疏松性骨折，但对于当前的医师和骨矿物质密度筛查中的医生和患者做法知之甚少，以识别出高骨折风险的患者。该提案描述了一项综合，指导的职业发展和研究计划，该计划将导致申请人的发展成为预防老龄化患者骨折的独立研究者。该建议的核心职业发展目标是通过对骨质疏松术筛查的模式进行调查和障碍，在大型国家行政数据集和调查方法中的筛查模式进行分析方面获得技能。总而言之，在该奖项结束时，我将在预防行为的民族模式，衡量风险感知和健康素养的方法论以及调查研究方面获得了技能。骨质疏松性骨折非常普遍，引起了极大的发病率，有证明的干预措施可以预防骨折，并且已经发布了提倡筛查的指南。尽管如此，其他预防保健的证据表明，采用骨质疏松症筛查将是缓慢的，并且会产生意外影响。如果了解当前的模式和护理骨质疏松症的障碍，则可以加速这种采用。为了建立这种理解，我们的目的是1）开发一种使用医疗保险行政索赔数据来评估骨矿物质密度（BMD）测试的速率2）检查BMD对患者特征的采用3）检查骨密度测试在骨密度测试中使用骨密度测试的患者在基准和生理学因素的使用方法和生理因素的相对贡献中，4）例如在初始分析中发现的年龄和SES。我们将在1998年至2002年研究来自三个州的妇女的医疗保险数据，并与AMA的医师信息有关，以检查目标1-4。然后，我们将调查初级保健患者，以评估风险感知，健康素养和算术以及其他障碍对筛查中患者差异的影响。重要的是，我们必须确定缺乏骨质疏松症筛查的患者，最少使用骨质疏松症的医生以及患者筛查障碍以改善未来骨质疏松症护理的障碍。

项目成果

期刊论文数量（5）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

A randomized study of the effect of 5-year and lifetime hip fracture risk information on physician recommendations for management of low bone density.

一项随机研究，研究 5 年和终生髋部骨折风险信息对医生治疗低骨密度建议的影响。

DOI：
10.1016/j.jocd.2007.07.005
发表时间：
2007
期刊：
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry
影响因子：
0
作者：
Neuner,JoanM;Laud,PurushottamW;Schapira,MarilynM
通讯作者：
Schapira,MarilynM