HipWatch: Osteoporosis investigation and treatment after a hip fracture: A 6-month randomized controlled trial

Abstract

Objective. We aimed to determine whether a novel Patient Empowerment and Physician Alerting (PEPA) intervention would improve the proportion of seniors who were investigated and treated for osteoporosis after hip fracture. Methods. We undertook a 6-month randomized controlled trial (RCT) in 48 women and men ≥ 60 years old who had suffered a hip fracture and were admitted to a tertiary-care university hospital. The primary outcome measure was the proportion of participants offered one or more osteoporosis-specific 'best practices' measured using the Diagnosis and Management Questionnaire (DMQ). Participant responses were validated in part by physician report. Results. In the PEPA intervention group, 19 (68%) were offered one or more components of best practice care compared with 7 (35%) in the 'usual care' group (p < .05). In the PEPA group, 15 (54%) (p < .01) were prescribed bisphosphonate therapy, 8 (29%) (p < .01) had a bone mineral density scan, 11 (39%) were prescribed calcium and vitamin D (p = .32), and 9 (32%) (p < .01) were prescribed exercise. In the usual care group, 0 (0%) were prescribed bisphosphonate therapy, a bone mineral density assessment, or exercise and 6(30%) were prescribed calcium and vitamin D. Conclusions. This simple, inexpensive PEPA intervention resulted in far superior clinical management than did usual care in a population at high risk of future hip fracture. Copyright 2007 by The Gerontological Society of America.