Evidence map›Paper›PMID 33566174›Full record

ArticleArchives of osteoporosis2021

Delivering fracture prevention services to rural US veterans through telemedicine: a process evaluation.

Karla L Miller, Melissa J Steffen, Kimberly D McCoy, Grant Cannon, Aaron T Seaman, Zachary L Anderson, Shardool Patel, Janiel Green, Shylo Wardyn, Samantha L Solimeo

Erratum issuedAbstract read
In one paragraph

Article in Archives of osteoporosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Return on investment of fracture liaison services: a systematic review and 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
    Pooled it
  2. Article
  3. Developing fracture liaison service framework based on comparative analysis and scoping 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
    Article
  4. Article
  5. Article
  6. Article
  7. Remote Management of Osteoporosis.Current treatment options in rheumatology · 2022
    Review
  8. Cultivating across "pockets of excellence": challenges to sustaining efforts to improve osteoporosis care.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Article
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Karla L MillerVA Office of Rural Health, Veterans Rural Health Resource Center-Salt Lake City (VRHRC-SLC), Salt Lake City, UT, USA. Karla.Miller@va.gov.ORCID https://orcid.org/0000-0001-9247-8957
Melissa J SteffenVA Office of Rural Health, Veterans Rural Health Resource Center-Salt Lake City (VRHRC-SLC), Salt Lake City, UT, USA.ORCID https://orcid.org/0000-0002-1889-9259
Kimberly D McCoyVA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Salt Lake City, UT, USA.ORCID https://orcid.org/0000-0002-2013-0393
Grant CannonDepartment of Internal Medicine, Rheumatology Section, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, USA.
Aaron T SeamanVA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Salt Lake City, UT, USA.ORCID https://orcid.org/0000-0002-1680-1334
Zachary L AndersonVA Office of Rural Health, Veterans Rural Health Resource Center-Salt Lake City (VRHRC-SLC), Salt Lake City, UT, USA.ORCID https://orcid.org/0000-0002-5260-1305
Shardool PatelVA Office of Rural Health, Veterans Rural Health Resource Center-Salt Lake City (VRHRC-SLC), Salt Lake City, UT, USA.ORCID https://orcid.org/0000-0002-0274-8800
Janiel GreenVA Office of Rural Health, Veterans Rural Health Resource Center-Salt Lake City (VRHRC-SLC), Salt Lake City, UT, USA.
Shylo WardynVA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Salt Lake City, UT, USA.
Samantha L SolimeoVA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Salt Lake City, UT, USA.ORCID https://orcid.org/0000-0002-3008-1230

Funding

The University of Iowa Clinical and Translational Science AwardKL2TR002536 · NCATS · UNIVERSITY OF IOWA · PI BASSUK, ALEXANDER G · 2018 to 2022
$3.3M
NCATS NIH HHS KL2 TR002536
6 · The paper itself

Abstract

An informatics-driven population bone health clinic was implemented to identify, screen, and treat rural US Veterans at risk for osteoporosis. We report the results of our implementation process evaluation which demonstrated BHT to be a feasible telehealth model for delivering preventative osteoporosis services in this setting. PURPOSE: An established and growing quality gap in osteoporosis evaluation and treatment of at-risk patients has yet to be met with corresponding clinical care models addressing osteoporosis primary prevention. The rural bone health tea m (BHT) was implemented to identify, screen, and treat rural Veterans lacking evidence of bone health care and we conducted a process evaluation to understand BHT implementation feasibility.

methodsFor this evaluation, we defined the primary outcome as the number of Veterans evaluated with DXA and a secondary outcome as the number of Veterans who initiated prescription therapy to reduce fracture risk. Outcomes were measured over a 15-month period and analyzed descriptively. Qualitative data to understand successful implementation were collected concurrently by conducting interviews with clinical personnel interacting with BHT and BHT staff and observations of BHT implementation processes at three site visits using the Promoting Action on Research Implementation in Health Services (PARIHS) framework.

resultsOf 4500 at-risk, rural Veterans offered osteoporosis screening, 1081 (24%) completed screening, and of these, 37% had normal bone density, 48% osteopenia, and 15% osteoporosis. Among Veterans with pharmacotherapy indications, 90% initiated therapy. Qualitative analyses identified barriers of rural geography, rural population characteristics, and the infrastructural resource requirement. Data infrastructure, evidence base for care delivery, stakeholder buy-in, formal and informal facilitator engagement, and focus on teamwork were identified as facilitators of implementation success.

conclusionThe BHT is a feasible population telehealth model for delivering preventative osteoporosis care to rural Veterans.

Indexed as

OsteoporosisTelemedicineVeteransHealth Services ResearchHumansRural PopulationFracturePrimary preventionRuralTelehealth

Identifiers

PMID33566174
PMCPMC7875846

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.