Improving Treatment of Newly Diagnosed Osteoporosis

这项申请的目的是支持和促进Peter Cram博士在 成为杰出的临床科学家和独立研究人员。对于这个应用程序，克拉姆博士有 组建了一支经验丰富的导师团队(Janet Schlechte博士(初级导师)、Alan Christensen(共同导师) 导师)和罗伯特·华莱士(共同导师))，以确保他的成功发展。克拉姆博士的研究将 重点关注骨质疏松症患者的治疗障碍。为了实现他的目标，克拉姆博士 会在导师的指导下，通过专注的教程和阅读材料，沉浸在严谨的学习中。他会的 还完成生物统计学和调查研究、健康心理学和 研究的道德行为。此外，在Schlechte博士的指导下，他将获得 骨质疏松患者的临床管理。在资助期内，候选人将进行 在三个不同的研究地点进行三个连续和递增的项目，以检查治疗障碍 双能X射线骨密度仪筛查确诊为骨质疏松症的患者 (DXA)扫描。项目1将涉及详细的病历审查，以确定患者和医生的具体情况 筛查DXA扫描后诊断为骨质疏松症患者治疗不足的相关因素。 项目2(从第18个月开始)将检查患者在收到DXA扫描通知时的偏好 结果。然后，调查人员将检查患者偏好之间的关系，以通知他们 结果与社会人口学和心理学特征有关。项目3(从第48个月开始)将基于 根据项目1和2的结果。这项随机试验将评估患者是否激活 干预措施，包括将DXA扫描结果和教育材料邮寄给患者 关于其结果的解读，可以提高骨质疏松症的治疗效果和患者满意度。 最后，这项工作将作为检查其他慢性疾病的障碍和改善治疗的模式 通过筛查确定的疾病。

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 Schlechte (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 absorptiometry (DXA) scan. Project 1 will involve a detailed medical record review to identify patient and physician-specific factors associatedwith undertreatment of patients diagnosed with osteoporosis after screening DXA scans. Project 2 (beginning in month 18) will examine patient preferences for being notified of their DXA scan results. The investigators will then examine relationships between 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 1and 2. This randomized trial will assess whether a patient activation intervention, consisting of mailing patients the results of their DXA scans along with educational 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.