- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT00175214
Controlled Trial to Increase Detection and Treatment of Osteoporosis in Older Patients With a Wrist Fracture
The primary objective of this proposed research is to improve the quality of care for patients who present to the Emergency Department with osteoporosis and a fracture of the wrist, by increasing the use of proven efficacious osteoporosis treatment. This is the primary study outcome, and it is defined as starting any one of hormone therapy, a bisphosphonate, raloxifene, or calcitonin within 6 months of a fracture of the wrist.
The study hypothesis is that a quality improvement intervention (with multiple components that include a notification system for primary care physicians, patient-specific reminders, locally generated treatment guidelines endorsed by opinion leaders, and patient education and counseling) will lead to increased use of proven efficacious osteoporosis treatments in patients eligible for secondary prevention. This hypothesis will be tested by comparing the intervention with usual care controls, in a prospective nonrandomized controlled trial.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
BACKGROUND: Osteoporosis is a progressive condition that causes a loss of bone mass, skeletal fragility, and fractures. Fractures result in pain, disability, deformity, and death. Osteoporosis is a major population health problem affecting 1.4 million Canadians, 25% of women and 12% of men over the age of 50 years. Current guidelines recommend aggressive secondary prevention in patients with osteoporosis who have suffered a fracture, because these patients have as high as a 20% risk of fracture in the following year, and because there are now proven efficacious treatments that can reduce this risk by 40-60%. Nevertheless, recent studies have shown that these patients are under-recognized and under-treated, demonstrating a care gap between evidence-based best practice and usual care. All patients with osteoporotic fractures (i.e., of the hip, vertebrae, or wrist) benefit from treatment. However, patients who present with a wrist fracture may be best suited to an intervention to improve secondary prevention practices, because wrist fractures are "sentinel events" in the natural history of osteoporosis: they are common, easily diagnosed, always present to medical attention, and occur years before the more devastating and costly fractures of the hip and vertebrae.
OBJECTIVES: The primary objective of this study is to improve the quality of care for patients who present to the ED with osteoporosis and a fracture of the wrist, by increasing the use of proven efficacious osteoporosis treatment. This is the primary study outcome, and it is defined as starting any one of hormone replacement therapy, a bisphosphonate, raloxifene, or calcitonin within 6 months of a fracture of the wrist.
HYPOTHESIS: A quality improvement intervention directed at patients and their primary care physicians will increase the use of proven efficacious osteoporosis treatment. The intervention itself has multiple components that include: a notification system and patient-specific reminders for primary care physicians, locally developed treatment guidelines endorsed by opinion leaders, and patient education and counseling. The study hypothesis will be tested by comparing the intervention to usual care controls, in a prospective nonrandomized controlled trial.
SPECIFIC AIMS: To determine whether the proposed intervention can-
- 1. Increase the use of proven efficacious osteoporosis treatment in patients with a fracture of the wrist,
- 2. Increase appropriate use of bone mineral density testing,
- 3. Increase patients' knowledge of osteoporosis and satisfaction.
Tipo de estudio
Inscripción
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
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Alberta
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Edmonton, Alberta, Canadá, T6G 2B7
- University Of Alberta Hospitals
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- age > 50 years
- any closed distal forearm fracture
- discharged home
Exclusion Criteria:
- unwilling or unable to provide consent
- admitted to hospital
- long term care resident
- residence outside Edmonton, Alberta
- unable to read and converse in English
- currently taking prescription osteoporosis treatment
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: No aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
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Increased use of proven efficacious osteoporosis treatment within six months of study enrollment, defined as: hormone therapy, a bisphosphonate, raloxifene, or calcitonin.
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Medidas de resultado secundarias
Medida de resultado |
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1. BMD testing
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2. Osteoporosis diagnosis
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3. Osteoporosis related knowledge
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4. Satisfaction
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5. Generic, Disease Specific, and Function-related QOL
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6. Falls, falls-related injuries, and fall interventions
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7. Persistence of effects and generalizability of effects
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8. 1, 2, 3 year outcomes
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Sumit R Majumdar, MD, MPH, University of Alberta
Publicaciones y enlaces útiles
Publicaciones Generales
- Majumdar SR, Rowe BH, Folk D, Johnson JA, Holroyd BH, Morrish DW, Maksymowych WP, Steiner IP, Harley CH, Wirzba BJ, Hanley DA, Blitz S, Russell AS. A controlled trial to increase detection and treatment of osteoporosis in older patients with a wrist fracture. Ann Intern Med. 2004 Sep 7;141(5):366-73. doi: 10.7326/0003-4819-141-5-200409070-00011.
- Majumdar SR, Johnson JA, Lier DA, Russell AS, Hanley DA, Blitz S, Steiner IP, Maksymowych WP, Morrish DW, Holroyd BR, Rowe BH. Persistence, reproducibility, and cost-effectiveness of an intervention to improve the quality of osteoporosis care after a fracture of the wrist: results of a controlled trial. Osteoporos Int. 2007 Mar;18(3):261-70. doi: 10.1007/s00198-006-0248-1. Epub 2006 Nov 4.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- AHFMR#2000000389
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
Ensayos clínicos sobre Osteoporosis
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Radius Health, Inc.TerminadoOsteoporosis | Riesgo de osteoporosis | Osteoporosis Posmenopáusica | Fractura de osteoporosis | Osteoporosis relacionada con la edad | Osteoporosis localizada en la columna vertebral | Osteoporosis senil | Osteoporosis de vértebras | Osteoporosis VertebralEstados Unidos
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AmgenTerminadoOsteoporosis posmenopáusica (OPM)Japón
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Appalachian State UniversityNorth Carolina Agriculture & Technical State UniversityTerminadoOsteoporosis posmenopáusica | Osteoporosis, OsteopeniaEstados Unidos
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Deltanoid PharmaceuticalsTerminadoOsteoporosis posmenopáusica, sitios múltiples
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Radius Health, Inc.TerminadoOsteoporosis | Osteoporosis relacionada con la edad | Osteoporosis relacionada con la edad | Osteoporosis localizada en la columna vertebral | Osteoporosis senil | Osteoporosis de vértebrasEstados Unidos, Polonia, Italia
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Organon and CoTerminadoOsteoporosis posmenopáusica
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AmgenTerminadoOsteoporosis posmenopáusicaEstados Unidos, Canadá, Dinamarca, Alemania, Bélgica, Colombia, Chequia, Japón, México, Polonia, Suiza, Hungría, España, Australia, Rumania, Reino Unido, India, Argentina, Brasil, República Dominicana, Estonia, Letonia, Lituania, Nueva Zelanda
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Penn State UniversityCalifornia Dried Plum BoardActivo, no reclutando
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Massachusetts General HospitalNational Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)TerminadoOsteoporosis posmenopáusicaEstados Unidos
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Sahlgrenska University Hospital, SwedenBioGaia ABTerminadoOsteoporosis posmenopáusicaSuecia