Improving Care of Osteoporosis: Multi-Modal Intervention to Increase Testing and Treatment (ICOMMIITT)
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Purpose
The purpose of this study is to rigorously test the incremental impact of simple, generalizable interventions to improve healthcare among older women at high risk for osteoporosis. Building on the experience of our University of Alabama at Birmingham (UAB) interdisciplinary team we have designed an innovative, scientifically rigorous, and highly feasible implementation research project in partnership with two Kaiser Permanente (KP) research centers. Kaiser Permanente, one of the Nation's largest Healthcare Organizations, uses an integrated electronic medical record (EMR), with full capture of pharmacy, clinical (including BMD results), and claims data, and cares for a racially/ethnically, socio-economically, and geographically diverse population. To address innovative questions in implementation research, we will perform a multi-modal group randomized trial involving over 18,000 patients seen by over 330 primary care providers (PCPs) at 25 KP facilities in the Northwest and Southeast. If proven effective, our system-centered and patient-centered approach will advance the state of implementation science and be applicable to evidence implementation in other musculoskeletal disorders and to other health care settings.
| Condition | Intervention |
|---|---|
|
Osteoporosis |
Behavioral: Patient educational DVD and brochure Behavioral: Physician web modules Behavioral: System |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Prevention |
| Official Title: | Improving Care of Osteoporosis: Multi-Modal Intervention to Increase Testing and Treatment (ICOMMIITT) |
- Bone Mineral Density (BMD) testing [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- Osteoporosis prescription medications [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- Patient-Physician communication regarding osteoporosis treatment and testing [ Time Frame: 12 months ] [ Designated as safety issue: No ]
| Enrollment: | 12128 |
| Study Start Date: | May 2010 |
| Study Completion Date: | October 2012 |
| Primary Completion Date: | December 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: educational materials
Patient educational DVD and brochure
|
Behavioral: Patient educational DVD and brochure
Construct a tailored direct-to-patient intervention to educate and activate older women about osteoporosis testing and treatment and aimed at improving patient-provider communication and "closing the loop" between knowledge communication and action. The intervention will include risk assessment, will be delivered through culturally/ethnically tailored "story-telling", and will be mailed-out as both a paper copy (Booklet) and an interactive DVD (allowing the patient to use the delivery mediums they are most comfortable with). A follow-up brochure will be sent as a "booster".
|
|
physician education
Physician web modules
|
Behavioral: Physician web modules
Web based osteoporosis continuing medical education (CME) materials
|
|
Experimental: System intervention
Self-referral letter with toll-free number provided
|
Behavioral: System
Create a practice redesign strategy to alert patients that they should receive a BMD test and provide them with direct patient access to schedule their own test
|
Eligibility| Ages Eligible for Study: | 65 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- female
- age 65 or older
Exclusion Criteria:
- prior osteoporosis testing (BMD)
- prior osteoporosis treatment
Contacts and Locations| United States, Georgia | |
| Kaiser Permanente Southeast | |
| Atlanta, Georgia, United States, 30305 | |
| United States, Oregon | |
| Kasier Permanente Northwest | |
| Portland, Oregon, United States, 97227 | |
| Principal Investigator: | Kenneth G Saag, MD, MSc | University of Alabama at Birmingham |
More Information
No publications provided
| Responsible Party: | Kenneth Saag, MD, MSc, Professor of Medicine, University of Alabama at Birmingham |
| ClinicalTrials.gov Identifier: | NCT00788632 History of Changes |
| Other Study ID Numbers: | X080219004 |
| Study First Received: | November 7, 2008 |
| Last Updated: | March 20, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of Alabama at Birmingham:
|
Osteoporosis BMD Bisphosphonates Educational materials Patient Stories |
Additional relevant MeSH terms:
|
Osteoporosis Bone Diseases, Metabolic Bone Diseases Musculoskeletal Diseases |
ClinicalTrials.gov processed this record on May 23, 2013