Institute for Physical Activity and Nutrition Research (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
The Australian Institute of Musculoskeletal Sciences (AIMSS), The University of Melbourne and Western Health, St Albans, Victoria, Australia.
BMJ Open. 2023 Apr 19;13(4):e067560. doi: 10.1136/bmjopen-2022-067560.
Despite evidence showing that timely diagnosis and appropriate pharmacological treatment of osteoporosis reduces subsequent fracture rates, osteoporosis remains significantly underdiagnosed and undertreated. The large and ongoing treatment gap for osteoporosis and associated fragility fractures could be addressed by considering systematic approaches for post-fracture care in the primary care setting. This study will develop the Integrating Post-Fracture Care into Primary Care (interFRACT) care program that aims to enhance diagnosis and treatment of osteoporosis and improve initiation and adherence to fracture prevention strategies for older adults in the primary care setting.
This mixed-methods study will follow an established co-design approach that involves six steps; the first three aim to gain an understanding of the consumer experience and needs, while the latter three focus on how to improve that experience through design and action. This will include: development of a Stakeholder Advisory Committee to provide guidance on all aspects of study design, including implementation, evaluation and dissemination; interviews with primary care physicians to explore beliefs and attitudes towards osteoporosis and fracture treatment; interviews with consumers (older adults with a diagnosis of osteoporosis and/or fragility fracture) to identify current needs for osteoporosis treatment and fracture prevention; a series of co-design workshops to develop the components of the interFRACT care program based on published guidance and findings from interviews; and a feasibility study with primary care physicians to determine the usability and acceptability of the interFRACT care program.
Ethical approval was obtained from Deakin University Human Research Ethics Committee (approval number: HEAG-H 56_2022). Study results will be published in peer-reviewed journals, presented at national and international conferences, and collated in reports for participating primary care practices.
尽管有证据表明，及时诊断和适当的药物治疗骨质疏松症可降低随后的骨折发生率，但骨质疏松症的诊断和治疗仍严重不足。在初级保健环境中考虑针对骨折后护理的系统方法，可以解决骨质疏松症和相关脆性骨折的巨大且持续存在的治疗差距。本研究将制定“将骨折后护理纳入初级保健（interFRACT）”护理方案，旨在提高初级保健环境中老年人骨质疏松症的诊断和治疗水平，并改善骨折预防策略的启动和坚持。
这项混合方法研究将遵循既定的共同设计方法，该方法包括六个步骤；前三个步骤旨在了解消费者的体验和需求，而后三个步骤则专注于如何通过设计和行动来改善这种体验。这将包括：成立利益相关者咨询委员会，为研究设计的各个方面提供指导，包括实施、评估和传播；对初级保健医生进行访谈，以探讨他们对骨质疏松症和骨折治疗的信念和态度；对消费者（被诊断患有骨质疏松症和/或脆性骨折的老年人）进行访谈，以确定他们对骨质疏松症治疗和骨折预防的当前需求；一系列共同设计研讨会，根据已发表的指南和访谈结果制定 interFRACT 护理方案的组成部分；以及一项针对初级保健医生的可行性研究，以确定 interFRACT 护理方案的可用性和可接受性。
已获得迪肯大学人类研究伦理委员会的伦理批准（批准编号：HEAG-H 56_2022）。研究结果将发表在同行评议的期刊上，在国家和国际会议上展示，并汇编成参与初级保健实践的报告。
