Abstract
BackgroundOsteoporosis is a serious but treatable condition. However, appropriate therapy utilization of the disease remains suboptimal. Thus, the objective of the study was to change physicians' therapy administration behavior in accordance with the Osteoporosis Canada 2002 guidelines.MethodsThe Project was a two year cohort study that consisted of five Quality Circle (QC) phases that included: 1) Training & Baseline Data Collection, 2) First Educational Intervention & First Follow-Up Data Collection 3) First Strategy Implementation Session, 4) Final Educational Intervention & Final Follow-up Data Collection, and 5) Final Strategy Implementation Session. A total of 340 family physicians formed 34 QCs and participated in the study. Physicians evaluated a total of 8376, 7354 and 3673 randomly selected patient charts at baseline, follow-up #1 and the final follow-up, respectively. Patients were divided into three groups; the high-risk, low-risk, and low-risk without fracture groups. The generalized estimating equations technique was utilized to model the change over time of whether physiciansResultsThe odds of appropriate therapy was 1.29 (95% CI: 1.13, 1.46), and 1.41 (95% CI: 1.20, 1.66) in the high risk group, 1.15 (95% CI: 0.97, 1.36), and 1.16 (95% CI: 0.93, 1.44) in the low risk group, and 1.20 (95% CI: 1.01, 1.43), and 1.23 (95% CI: 0.97, 1.55) in the low risk group without fractures at follow-up #1 and the final follow-up, respectively.ConclusionQCs methodology was successful in increasing physicians' appropriate use of osteoporosis medications in accordance with Osteoporosis Canada guidelines.
Highlights
Osteoporosis is a serious but treatable condition
Results indicated that appropriate drug therapies including calcium and vitamin D were offered to only 36% of the diagnosed patients [18]
Circle members were family physicians selected from specific geographical regions across Canada to form the Quality Circle (QC)
Summary
Osteoporosis is a serious but treatable condition. appropriate therapy utilization of the disease remains suboptimal. A search conducted from a claims database in 30 states by Freedman et al identified 1162 women, age 55 years or older who had a distal radial fracture. Of these patients, only 22.9% were treated with at least one of the medications approved for treatment of established osteoporosis [17]. Data from the National Ambulatory Medical Care Survey from 1993 to 1997 were examined for evidence of treatment for osteoporosis or vertebral fracture during visits by women 60 years of age and older to family physicians. Results indicated that appropriate drug therapies including calcium and vitamin D were offered to only 36% of the diagnosed patients [18]
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