高风险男性的骨质疏松查远程骨健康服务:一个集群随机临床试验
Cathleen Colón-Emeric1,2, Richard Lee1,2, Kenneth W Lyles1,2
1Geriatrics Research Education and Clinical Center and Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health System, Durham, North Carolina.
远程骨健康服务显著改善了骨质疏松症查,治疗和老年男性骨折风险因素的坚持. 这种模型的患者和临床医生接受度很高,发现了许多骨质疏松症或骨质疏松症的病例.
科学领域:
- 老年医学
- 公共卫生
- 临床试验
背景情况:
- 男人骨质疏松症查缺乏可靠的证据和有效的初级保健模式.
- 在有骨折风险的老年男性中,需要改善骨质疏松症查和治疗坚持.
研究的目的:
- 评估中心化,远程骨健康服务 (BHS) 对骨质疏松症查,治疗开始,坚持和骨密度的影响.
主要方法:
- 一个集群随机临床试验,涉及2个退伍军人卫生系统的39个初级保健团队.
- 包括3112名年龄在65-85岁的男性退伍军人,至少有一个骨折风险因素,但没有先前的骨折.
- 干预组接受了包括DXA查,电子咨询和护理管理在内的远程BHS;对照组接受了通常的护理和指导方针.
主要成果:
- 骨质疏松症查率在BHS组 (49. 2%) 与常规治疗 (2. 3%) 相比显著更高.
- 超过一半的查患者患有骨质疏松症或骨质疏松症.
- BHS组的骨质疏松症治疗率高 (84. 4%),坚持治疗 (91. 7% 覆盖日),持续治疗 (平均657天).
- 在24个月后,腿部部T分数的趋势有利于BHS组.
结论:
- 一个集中,远程的骨健康服务模式有效地提高了骨质疏松症的查,治疗和风险老年男性的坚持.
- 在骨折之前根据临床风险因素进行查的效果很高.
- 需要在不同环境下进行进一步的验证和更长的随访,以评估骨折减少.
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