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针对高风险老年患者的促进骨骼健康的医疗提供者教育干预。

An educational intervention for providers to promote bone health in high-risk older patients.

机构信息

Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.

出版信息

J Am Geriatr Soc. 2011 Feb;59(2):291-6. doi: 10.1111/j.1532-5415.2010.03240.x. Epub 2011 Feb 2.

Abstract

OBJECTIVES

To design, implement, and assess an educational intervention for providers focused on osteoporosis screening and management in older patients with chronic obstructive pulmonary disease or asthma who have been prescribed prolonged courses of oral or high-dose inhaled corticosteroids or both and are therefore at high risk for bone loss and fractures.

DESIGN

One-group pretest-posttest.

SETTING

Academic outpatient pulmonary practice.

PARTICIPANTS

Nineteen pulmonary specialists at an academic medical center.

INTERVENTION

Educational theory and a needs assessment and attitude survey guided the development of a multicomponent educational intervention.

MEASUREMENTS

Change in provider behavior was assessed by auditing the electronic medical records for adherence to osteoporosis management guidelines in high-risk patients seen by participants at baseline and for 6 months after the educational intervention. Knowledge transfer and changes in attitude were assessed using pre- and posttests and surveys.

RESULTS

A 19% increase in overall rate of adherence to osteoporosis management guidelines in high-risk patients was observed: 45% before intervention to 64% after intervention (n=249 patients, P=.003). Postintervention surveys and test scores also showed statistically significant gains from baseline.

CONCLUSION

An educational intervention improved adherence to osteoporosis management guidelines of academic pulmonary specialists. The results of this study provide evidence for the positive effect of a multimodal educational program in altering practice behaviors.

摘要

目的

设计、实施并评估一项针对医疗服务提供者的教育干预措施,重点关注因长期使用口服或高剂量吸入性皮质类固醇激素或两者兼用而处于骨质流失和骨折高风险的慢性阻塞性肺疾病或哮喘老年患者的骨质疏松症筛查和管理。

设计

单组前后测试。

地点

学术门诊肺科诊所。

参与者

一家学术医疗中心的 19 名肺病专家。

干预措施

教育理论、需求评估和态度调查指导了多方面教育干预措施的制定。

测量

通过审核参与者在基线和教育干预后 6 个月期间就诊的高风险患者的电子病历,评估提供者行为的变化,以评估对骨质疏松症管理指南的遵守情况。使用前后测试和调查评估知识转移和态度变化。

结果

观察到高风险患者总体遵循骨质疏松症管理指南的比率增加了 19%:干预前为 45%,干预后为 64%(n=249 例患者,P=.003)。干预后的调查和测试分数也显示出与基线相比有统计学意义的提高。

结论

教育干预措施提高了学术肺病专家对骨质疏松症管理指南的遵循率。这项研究的结果为多模式教育计划在改变实践行为方面的积极效果提供了证据。

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