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HipWatch: osteoporosis investigation and treatment after a hip fracture: a 6-month randomized controlled trial
Davis JC, Guy P, Ashe MC, Liu-Ambrose T, Khan K
The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 2007 Aug;62(8):888-891
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: We aimed to determine whether a novel Patient Empowerment and Physician Alerting (PEPA) intervention would improve the proportion of seniors who were investigated and treated for osteoporosis after hip fracture. METHODS: We undertook a 6-month randomized controlled trial (RCT) in 48 women and men >= 60 years old who had suffered a hip fracture and were admitted to a tertiary-care university hospital. The primary outcome measure was the proportion of participants offered one or more osteoporosis-specific 'best practices' measured using the Diagnosis and Management Questionnaire (DMQ). Participant responses were validated in part by physician report. RESULTS: In the PEPA intervention group, 19 (68%) were offered one or more components of best practice care compared with 7 (35%) in the 'usual care' group (p < 0.05). In the PEPA group, 15 (54%) (p < 0.01) were prescribed bisphosphonate therapy, 8 (29%) (p < 0.01) had a bone mineral density scan, 11 (39%) were prescribed calcium and vitamin D (p = 0.32), and 9 (32%) (p < 0.01) were prescribed exercise. In the usual care group, 0 (0%) were prescribed bisphosphonate therapy, a bone mineral density assessment, or exercise and 6 (30%) were prescribed calcium and vitamin D. CONCLUSIONS: This simple, inexpensive PEPA intervention resulted in far superior clinical management than did usual care in a population at high risk of future hip fracture.
Copyright the Gerontological Society of America. Reproduced by permission of the publisher.

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