Evidence map›Paper›PMID 22184366›Full record

Trial reportCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2012

Closing the gap in postfracture care at the population level: a randomized controlled trial.

William D Leslie, Lisa LaBine, Penny Klassen, Darlene Dreilich, Patricia A Caetano

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00594789 (Closing The Post Fracture Care Gap In Manitoba), which is not on this map. Cited by 37 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00594789 naactive not recruitingnot on this map

Closing The Post Fracture Care Gap In Manitoba

TypeinterventionalSponsorUniversity of ManitobaRan2008 to 2028Enrolled4,264ConditionsOsteoporosisArmsInformation letters
3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Interventions to improve osteoporosis care: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020
    Pooled it
  5. How Can We Improve Osteoporosis Care? A Systematic Review and Meta-Analysis of the Efficacy of Quality Improvement Strategies for Osteoporosis.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2018
    Pooled it
  6. Identifying characteristics of an effective fracture liaison service: systematic literature review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018
    Pooled it
  7. Complex interventions can increase osteoporosis investigations and treatment: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018
    Pooled it
  8. Pooled it
  9. Adherence to osteoporosis therapy after an upper extremity fracture: a pre-specified substudy of the C-STOP randomized controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019
    Trial
  10. Evaluation of a Multimodal, Direct-to-Patient Educational Intervention Targeting Barriers to Osteoporosis Care: A Randomized Clinical Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2018
    Trial
  11. Post-fracture care: do we need to educate patients rather than doctors? The PREVOST randomized controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017
    Trial
  12. Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016
    Trial
  13. Activating Patients With a Tailored Bone Density Test Results Letter and Educational Brochure: the PAADRN Randomized Controlled Trial.Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry
    Trial
  14. Osteoporosis and post-fracture management in the primary care setting: a systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Review
  15. Article
  16. Introduction of an order set after hip fracture improves osteoporosis medication initiation and persistence: a population-based before-after analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024
    Article
  17. Secondary fracture prevention in primary care: a narrative review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

William D LeslieUniversity of Manitoba, Winnipeg, Man. bleslie@sbgh.mb.ca
Lisa LaBine
Penny Klassen
Darlene Dreilich
Patricia A Caetano

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostfracture care is suboptimal, and strategies to address this major gap in care are necessary. We investigated whether notifications sent by mail to physicians and patients would lead to improved postfracture care.

methodsWe conducted a randomized controlled trial (ClinicalTrials.gov identifier NCT00594789) in the province of Manitoba, Canada, from June 2008 to May 2010. Using medical claims data, we identified 4264 men and women age 50 years or older who recently reported major fractures, and who had not undergone recent bone mineral density testing or treatment for osteoporosis. Participants were randomized to three groups: group 1 received usual care (n = 1480), patients in group 2 had mailed notification of the fracture sent to their primary care physicians (n = 1363), and group 3 had notifications sent to both physicians and patients (n = 1421). Bone mineral density testing and the start of pharmacologic treatment for osteoporosis within the following 12 months were documented.

resultsAmong participants in group 1 (usual care), 15.8% of women and 7.6% of men underwent testing for bone mineral density or started pharmacologic treatment for osteoporosis. Outcome measures improved among participants in group 2 (30.3% of women and 19.0% of men, both p < 0.001) and group 3 (34.0% of women and 19.8% of men, both p < 0.001). No additional benefit was seen with patient notification in addition to physician notification. Combining groups 2 and 3, the absolute increase for the combined end point of bone mineral density testing or pharmacologic treatment was 14.9% (16.4% among women, 11.8% among men). The number needed to notify to change patient care was 7 (6 for women, 6 for men). The adjusted odds ratio (OR) to change patient care in group 2 was 2.45 (95% confidence interval [CI] 2.01-2.98); for group 3 the OR was 2.82 (95% CI 2.33-3.43).

interpretationThis notification system provides a relatively simple way to enhance post-fracture care.

Indexed as

Continuity of Patient CareAgedAged, 80 and overBone DensityFemaleFractures, BoneHumansMaleMiddle AgedOsteoporosisPrimary Health Care

Identifiers

PMID22184366
PMCPMC3281153

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.