A knowledge translation tool improved osteoporosis disease management in primary care: an interrupted time series analysis

Implementation Science

Sharon E Straus¹  David Newton⁴  Christine Marquez⁴  Joycelyne Ewusie²  Mark Chignell⁵  Kevin Thorpe³  Maggie Chen⁴  Jemila Hamid²  Anna M Sawka⁶  Monika Kastner⁴ 

[1] Faculty of Medicine, University of Toronto, Toronto, ON, Canada;Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada;Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada;Li Ka Shing Knowledge Institute of St. Michael¿s Hospital, Toronto, ON, Canada;Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada;Division of Endocrinology, University Health Network and University of Toronto, Toronto, ON, Canada

关键词: Interrupted time series analysis;    Osteoporosis;    Risk assessment;    Primary care;    Chronic disease management;    Clinical decision support;    Knowledge translation;   

Others  :  1146444
DOI  :  10.1186/s13012-014-0109-9

 received in 2013-11-16, accepted in 2014-08-11,  发布年份 2014

【 摘 要 】

Background

Osteoporosis affects over 200 million people worldwide at a high cost to healthcare systems, yet gaps in management still exist. In response, we developed a multi-component osteoporosis knowledge translation (Op-KT) tool involving a patient-initiated risk assessment questionnaire (RAQ), which generates individualized best practice recommendations for physicians and customized education for patients at the point of care. The objective of this study was to evaluate the effectiveness of the Op-KT tool for appropriate disease management by physicians.

Methods

The Op-KT tool was evaluated using an interrupted time series design. This involved multiple assessments of the outcomes 12 months before (baseline) and 12 months after tool implementation (52 data points in total). Inclusion criteria were family physicians and their patients at risk for osteoporosis (women aged ?50 years, men aged ?65 years). Primary outcomes were the initiation of appropriate osteoporosis screening and treatment. Analyses included segmented linear regression modeling and analysis of variance.

Results

The Op-KT tool was implemented in three family practices in Ontario, Canada representing 5 family physicians with 2840 age eligible patients (mean age 67 years; 76% women). Time series regression models showed an overall increase from baseline in the initiation of screening (3.4%; P?

Conclusions

The multicomponent Op-KT tool significantly increased osteoporosis investigations in three family practices, and highlights its potential to facilitate patient self-management. Next steps include wider implementation and evaluation of the tool in primary care.

【 授权许可】

   
2014 Kastner et al.; licensee BioMed Central Ltd.

【 图 表 】

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Figure 1.

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