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A Patient Activation Intervention to Enhance Bone Health

增强骨骼健康的患者激活干预措施

基本信息

批准号：
8738554
负责人：
Fredric D Wolinsky
金额：
$ 101.71万
依托单位：
UNIVERSITY OF IOWA
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-05-01 至 2017-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8738554
关键词：
1 year old Adult Advisory Committees Age Aging Alcohol consumption Behavior Therapy Bone Density Calcium Caring Chronic Disease Client satisfaction Clinical Clinical Practice Guideline Communication Cues Direct Costs Effectiveness of Interventions Elderly Epidemiologic Studies Exercise Failure Fracture Guidelines Health Care Costs Healthcare Intake Intervention Knowledge Letters Mails Measures Modeling Modification Nursing Faculty Osteopenia Osteoporosis Patients Pharmacotherapy Population Prevalence Preventive Provider Quality of Care Quality of life Randomized Controlled Trials Research Research Personnel Risk Risk Factors Scanning Self Care Services Site Subgroup Supplementation Surgeon Telephone Test Result Testing Time Tobacco Use Cessation Vitamin D Weight-Bearing state Woman base behavior change bone bone health bone loss bone quality clinically relevant cost cost effectiveness design economic evaluation emerging adult follow-up health belief improved men novel patient population preference prevent public health relevance response satisfaction screening smoking cessation treatment as usual young adult

项目摘要

DESCRIPTION (provided by applicant): Bone mineral density (BMD) peaks in early adulthood and declines progressively with aging. As BMD declines from normal, to low (formerly called osteopenia), to osteoporosis, risk of fractures progressively increases. In an effort to prevent bone loss and reduce fracture risk, most widely accepted guidelines including the U.S. Preventive Services Task Force and Surgeon General's Office now recommend BMD screening of older adults using dual energy x-ray absorptiometry (DXA). The rationale for screening is that patients and their providers will use DXA results as a "cue to action" and take necessary steps to enhance bone health through lifestyle modification (e.g., weight bearing exercise), Calcium/Vitamin D supplementation, and pharmacotherapy when indicated. However, multiple studies have demonstrated that patients and providers often fail take recommended actions following DXA testing, thus defeating much of the purpose of screening. Over the past five years we have systematically developed and pilot tested a low-cost and practical patient activation intervention based upon the Health Belief Model. The intervention consists of the DXA scanning center mailing each patient a customized letter containing the results of their DXA scan plus educational information about osteoporosis, supplemented by a follow-up phone call from a nurse educator. Preliminary studies have demonstrated that the intervention is well received by both patients and providers and enhances bone-related quality of care. The overarching objective of the current proposal is to rigorously examine the impact of our patient activation intervention on bone-related quality of care in adults undergoing screening DXA scans through a randomized-controlled trial conducted at three study sites. In addition, we will examine the real-world costs associated with our intervention and the impact of our intervention on the overall cost-effectiveness of BMD screening. We hypothesize that the activation intervention will increase optimization of Calcium/Vitamin D intake, enhance use of pharmacotherapy when indicated, will improve patient satisfaction with their bone-related healthcare, and improve patients' osteoporosis specific knowledge when compared with usual care.

描述（由申请人提供）：骨矿物质密度（BMD）在成年早期达到峰值，并随着年龄的增长而逐渐下降。随着BMD从正常下降到低（以前称为骨质减少），再到骨质疏松症，骨折的风险逐渐增加。为了防止骨质流失和降低骨折风险，包括美国预防服务工作组和外科医生办公室在内的最广泛接受的指南现在建议使用双能X射线吸收测定法（DXA）对老年人进行BMD筛查。筛查的基本原理是，患者及其提供者将使用DXA结果作为“行动提示”，并采取必要措施，通过改变生活方式（例如，负重运动）、钙/维生素D补充和药物治疗（如有指征）。然而，多项研究表明，患者和医疗服务提供者在DXA测试后经常未能采取建议的行动，从而违背了筛查的大部分目的。在过去的五年里，我们系统地开发和试点测试了一个低成本和实用的病人激活干预的基础上的健康信念模型。干预措施包括DXA扫描中心向每位患者邮寄一封定制的信件，其中包含DXA扫描结果以及有关骨质疏松症的教育信息，并辅以护士教育者的后续电话。初步研究表明，干预措施受到患者和提供者的欢迎，并提高了与骨骼相关的护理质量。当前提案的总体目标是通过在三个研究中心进行的随机对照试验，严格检查我们的患者激活干预对接受DXA筛查扫描的成人骨相关护理质量的影响。此外，我们将研究与我们的干预措施相关的实际成本，以及我们的干预措施对BMD筛查总体成本效益的影响。我们假设，与常规护理相比，激活干预将增加钙/维生素D摄入的优化，在有指征时加强药物治疗的使用，将提高患者对其骨相关医疗保健的满意度，并提高患者骨质疏松症的具体知识。

项目成果

期刊论文数量（25）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

General hospitals, specialty hospitals and financially vulnerable patients.

综合医院、专科医院和经济困难的患者。

DOI：
发表时间：
2009
期刊：
Research brief
影响因子：
0
作者：
Tynan,Ann;November,Elizabeth;Lauer,Johanna;Pham,HoangmaiH;Cram,Peter
通讯作者：
Cram,Peter

Diet and exercise changes following bone densitometry in the Patient Activation After DXA Result Notification (PAADRN) study.

在 DXA 结果通知后患者激活 (PAADRN) 研究中，骨密度测量后饮食和运动的变化。

DOI：
10.1007/s11657-017-0402-8
发表时间：
2018
期刊：
Archives of osteoporosis
影响因子：
3
作者：
Roblin,DouglasW;Cram,Peter;Lou,Yiyue;Edmonds,StephanieW;Hall,SylvieF;Jones,MichaelP;Saag,KennethG;Wright,NicoleC;Wolinsky,FredricD;PAADRNInvestigators
通讯作者：
PAADRNInvestigators

Proposed interventions to decrease the frequency of missed test results.

建议采取干预措施以减少错过测试结果的频率。