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Randomized trial to improve fracture prevention in nursing home residents.

Publication ,  Journal Article
Colón-Emeric, CS; Lyles, KW; House, P; Levine, DA; Schenck, AP; Allison, J; Gorospe, J; Fermazin, M; Oliver, K; Curtis, JR; Weissman, N ...
Published in: Am J Med
October 2007

BACKGROUND: Interventions to improve the fracture prevention in nursing homes are needed. METHODS: Cluster-randomized, single-blind, controlled trial of a multi-modal quality improvement intervention. Nursing homes (n=67) with > or =10 residents with a diagnosis of osteoporosis or recent hip fracture (n=606) were randomized to receive an early or delayed intervention consisting of audit and feedback, educational modules, teleconferences, and academic detailing. Medical record abstraction and the Minimum Data Set were used to measure the prescription of osteoporosis therapies before and after the intervention period. Analysis was at the facility-level and Generalized Estimating Equation modeling was used to account for clustering. RESULTS: No significant improvements were observed in any of the quality indicators. The use of osteoporosis pharmacotherapy or hip protectors improved by 8.0% in the intervention group and 0.6% in the control group, but the difference was not statistically significant (P=.72). Participation in the intervention activities was low, but completion of the educational module (odds ratio [OR] 4.8, 95% confidence interval [CI], 1.9-12.0) and direct physician contact by an academic detailer (OR 4.5, 95% CI, 1.1-18.2) were significantly associated with prescription of osteoporosis pharmacotherapy or hip protectors in multivariable models. CONCLUSIONS: Audit-feedback and education interventions were ineffective in improving fracture prevention in the nursing home setting, although results may have been tempered by low participation in the intervention activities.

Duke Scholars

Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

October 2007

Volume

120

Issue

10

Start / End Page

886 / 892

Location

United States

Related Subject Headings

  • Single-Blind Method
  • Quality Assurance, Health Care
  • Outcome and Process Assessment, Health Care
  • Osteoporosis
  • Odds Ratio
  • Nursing Homes
  • North Carolina
  • Multivariate Analysis
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Colón-Emeric, C. S., Lyles, K. W., House, P., Levine, D. A., Schenck, A. P., Allison, J., … Saag, K. G. (2007). Randomized trial to improve fracture prevention in nursing home residents. Am J Med, 120(10), 886–892. https://doi.org/10.1016/j.amjmed.2007.04.020
Colón-Emeric, Cathleen S., Kenneth W. Lyles, Paul House, Deborah A. Levine, Anna P. Schenck, Jeroan Allison, Joel Gorospe, et al. “Randomized trial to improve fracture prevention in nursing home residents.Am J Med 120, no. 10 (October 2007): 886–92. https://doi.org/10.1016/j.amjmed.2007.04.020.
Colón-Emeric CS, Lyles KW, House P, Levine DA, Schenck AP, Allison J, et al. Randomized trial to improve fracture prevention in nursing home residents. Am J Med. 2007 Oct;120(10):886–92.
Colón-Emeric, Cathleen S., et al. “Randomized trial to improve fracture prevention in nursing home residents.Am J Med, vol. 120, no. 10, Oct. 2007, pp. 886–92. Pubmed, doi:10.1016/j.amjmed.2007.04.020.
Colón-Emeric CS, Lyles KW, House P, Levine DA, Schenck AP, Allison J, Gorospe J, Fermazin M, Oliver K, Curtis JR, Weissman N, Xie A, Saag KG. Randomized trial to improve fracture prevention in nursing home residents. Am J Med. 2007 Oct;120(10):886–892.
Journal cover image

Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

October 2007

Volume

120

Issue

10

Start / End Page

886 / 892

Location

United States

Related Subject Headings

  • Single-Blind Method
  • Quality Assurance, Health Care
  • Outcome and Process Assessment, Health Care
  • Osteoporosis
  • Odds Ratio
  • Nursing Homes
  • North Carolina
  • Multivariate Analysis
  • Middle Aged
  • Male