Strategies to overcome barriers to implementing osteoporosis and fracture prevention guidelines in long-term care: a qualitative analysis of action plans suggested by front line staff in Ontario, Canada

BMC Geriatrics

Alexandra Papaioannou³  Carly J. Skidmore¹  Lynne Lohfeld³  Sharon Marr¹  Courtney C. Kennedy³  Sultan H. Alamri² 

[1] Juravinski Research Centre, Hamilton Health Sciences - St. Peter’s Hospital, 88 Maplewood Avenue, Hamilton L8M 1 W9, ON, Canada;Geriatrics Residency Program, St. Joseph’s Hospital, McMaster University, 50 Charlton Ave. E., Hamilton L8N 4A6, ON, Canada;Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main St. West, Hamilton L8S4K1, ON, Canada

关键词: Qualitative;    Prevention;    Fractures;    Osteoporosis;    Barriers;   

Others  :  1221652
DOI  :  10.1186/s12877-015-0099-8

 received in 2015-02-15, accepted in 2015-07-28,  发布年份 2015

【 摘 要 】

Background

Osteoporosis is a major global health problem, especially among long-term care (LTC) facilities. Despite the availability of effective clinical guidelines to prevent osteoporosis and bone fractures, few LTC homes actually adhere to these practical recommendations. The purpose of this study was to identify barriers to the implementation of evidence-based practices for osteoporosis and fracture prevention in LTC facilities and elicit practical strategies to address these barriers.

Methods

We performed a qualitative analysis of action plans formulated by Professional Advisory Committee (PAC) teams at 12 LTC homes in the intervention arm of the Vitamin D and Osteoporosis Study (ViDOS) in Ontario, Canada. PAC teams were comprised of medical directors, administrators, directors of care, pharmacists, dietitians, and other staff. Thematic content analysis was performed to identify the key themes emerging from the action plans.

Results

LTC teams identified several barriers, including lack of educational information and resources prior to the ViDOS intervention, difficulty obtaining required patient information for fracture risk assessment, and inconsistent prescribing of vitamin D and calcium at the time of admission. The most frequently suggested recommendations was to establish and adhere to standard admission orders regarding vitamin D, calcium, and osteoporosis therapies, improve the use of electronic medical records for osteoporosis and fracture risk assessment, and require bone health as a topic at quarterly reviews and multidisciplinary conferences.

Conclusions

This qualitative study identified several important barriers and practical recommendations for improving the implementation of osteoporosis and fracture prevention guidelines in LTC settings.

【 授权许可】

   
2015 Alamri et al.

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