Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA, USA.
Am J Manag Care. 2009 Aug 1;15(8):e60-70.
To evaluate the effectiveness of a telephone-based "virtual" osteoporosis clinic in increasing the use of osteoporosis medication assessed at 1 year after receipt of a prescription.
Randomized controlled trial.
Women 60 years and older with previously undiagnosed osteoporosis were randomized to evaluation and treatment by a dedicated telephone-based osteoporosis clinic with monthly telephone follow-up until medication was successfully started (intervention) or to usual care provided by their primary care physician (control). A successful outcome was defined as having filled a prescription for a 3-month supply of medication within 130 days, marking 1 year and 30 days since enrollment.
A total of 235 women underwent randomization, and 211 received the allocation. Of 109 women in the telephone-based osteoporosis clinic group, 75 (68.8%) were using osteoporosis medication at 1 year compared with 46 of 102 women (45.1%) in the usual care group (P <.001). A poststudy questionnaire showed no significant differences between the groups in regard to knowledge about osteoporosis or attitude toward their osteoporosis care provider. The significant increase in osteoporosis medication use with the telephone intervention occurred at the same time that an independent health maintenance organization-wide program promoting osteoporosis treatment seemed to improve overall rates of use.
The use of osteoporosis medication among women with newly diagnosed osteoporosis may be significantly improved by a simple intervention based on monthly telephone follow-up. Overall use of osteoporosis medication in this trial may have been increased by a systemwide initiative to improve osteoporosis care conducted concurrently with the trial. (ClinicalTrials.gov Identifier: NCT00145067.).
评估基于电话的“虚拟”骨质疏松症诊所是否能提高接受处方后 1 年内使用骨质疏松症药物的效果。
随机对照试验。
将先前未确诊骨质疏松症的 60 岁及以上女性随机分配至专门的基于电话的骨质疏松症诊所进行评估和治疗,每月通过电话进行随访,直至成功开始用药(干预组)或由其初级保健医生提供常规护理(对照组)。成功的结果定义为在 130 天内开了 3 个月剂量的药物处方,标志着从入组开始已经过去了 1 年零 30 天。
共有 235 名女性接受了随机分组,211 名女性接受了分配。在基于电话的骨质疏松症诊所组的 109 名女性中,有 75 名(68.8%)在 1 年内使用了骨质疏松症药物,而在常规护理组的 102 名女性中,有 46 名(45.1%)使用了骨质疏松症药物(P<.001)。一项后续问卷调查显示,两组在骨质疏松症知识或对骨质疏松症护理提供者的态度方面没有显著差异。随着电话干预的显著增加,独立的健康维护组织范围内的骨质疏松症治疗促进计划似乎也提高了总体使用率。
通过每月电话随访的简单干预,可以显著提高新诊断为骨质疏松症的女性使用骨质疏松症药物的比例。在本试验中,总体上使用骨质疏松症药物的比例可能由于与试验同时进行的旨在改善骨质疏松症护理的全系统倡议而有所提高。(临床试验注册号:NCT00145067。)