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Own the Bone, a System-Based Intervention, Improves Osteoporosis Care After Fragility Fractures
Andrew D Bunta1, Beatrice J Edwards, William B Macaulay
11Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois 2Department of General Internal Medicine, The University of Texas, MD Anderson Cancer Center, Houston, Texas 3Department of Orthopaedic Surgery, Columbia University, New York, NY 4Department of Orthopaedic Surgery, Greenville Hospital System, University Medical Center, University of South Carolina, Greenville, South Carolina 5Department of Orthopaedic Surgery, Children's National Health System, Washington, DC 6The Center for Orthopedic Research and Education, Trauma and Bone Health, Banner Health, Phoenix, Arizona 7John Kaufman Orthopaedics, Valencia, California 8American Orthopaedic Association, Rosemont, Illinois 9Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan 10Department of Orthopaedics and Rehabilitation, Yale University, New Haven, Connecticut 11Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota 12Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago, Chicago, Illinois.
Background:
The goal of this study was to evaluate the effectiveness of the American Orthopaedic Association's Own the Bone secondary fracture prevention program in the United States.
Methods:
The objective of this quality improvement cohort study was dissemination of Own the Bone and implementation of secondary prevention (osteoporosis pharmacologic and bone mineral density [BMD] test recommendations). The main outcome measures were the number of sites implementing Own the Bone and implementation of secondary prevention, i.e., orders for BMD testing and/or pharmacologic treatment. The 177 sites participating in the program were academic and community hospitals, orthopaedic surgery groups, and a health system; data were obtained from the first 125 sites utilizing its registry, between January 1, 2010, and March 31, 2015. It included all patients, aged 50 years or older, presenting with fragility fractures (n = 23,132) who were enrolled in the Own the Bone web-based registry. The interventions were education, development of program elements, dissemination, implementation, and evaluation of the Own the Bone program at participating sites.
Results:
A growing number of institutions implemented Own the Bone (14 sites in 2005-2006 to 177 sites in 2015). After consultation, 53% of patients had a BMD test ordered and/or pharmacologic therapy for osteoporosis.
Conclusions:
The Own the Bone intervention has succeeded in improving the behaviors of medical professionals in the areas of osteoporosis treatment and counseling, BMD testing, initiation of pharmacotherapy, and coordination of care for patients who have experienced a fragility fracture.
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