Patient Activation After DXA Result Notification



Status:Completed
Conditions:Osteoporosis, Orthopedic, Endocrine, Gastrointestinal
Therapuetic Areas:Endocrinology, Gastroenterology, Rheumatology, Orthopedics / Podiatry
Healthy:No
Age Range:50 - Any
Updated:7/1/2018
Start Date:February 2012
End Date:November 2015

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There is growing evidence that patients undergoing bone mineral density testing (BMD) often
do not take important steps to improve their bone health. The investigators will conduct a
randomized-controlled trial to evaluate the impact of a novel and practical patient
activation intervention (mailing patients their bone density test results) on the quality of
bone-related healthcare and the cost-effectiveness of BMD testing. Equally important, the
investigators intervention could easily be modified to include other patient populations and
chronic diseases.

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

Inclusion Criteria:

1. patients presenting for DXA

2. age 50 years of age or older

Exclusion Criteria:

1. non-English speakers

2. prisoners

3. people who have mental disabilities

4. individuals younger than age 50 years

5. individuals who do not have access to a telephone

6. deaf patients
We found this trial at
4
sites
Atlanta, Georgia 30305
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Atlanta, GA
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1720 2nd Ave S
Birmingham, Alabama 35233
(205) 934-4011 
University of Alabama at Birmingham The University of Alabama at Birmingham (UAB) traces its roots...
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Birmingham, AL
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101 Jessup Hall
Iowa City, Iowa 52242
(319) 335-3500
University of Iowa With just over 30,000 students, the University of Iowa is one of...
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Iowa City, IA
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Toronto, Ontario
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Toronto,
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