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1.
BMC Geriatr ; 10: 60, 2010 Aug 27.
Article in English | MEDLINE | ID: mdl-20799973

ABSTRACT

BACKGROUND: Osteoporosis-related fractures are a significant public health concern. Interventions that increase detection and treatment of osteoporosis are underutilized. This pragmatic randomised study was done to evaluate the impact of a multifaceted community-based care program aimed at optimizing evidence-based management in patients at risk for osteoporosis and fractures. METHODS: This was a 12-month randomized trial performed in Ontario, Canada. Eligible patients were community-dwelling, aged ≥55 years, and identified to be at risk for osteoporosis-related fractures. Two hundred and one patients were allocated to the intervention group or to usual care. Components of the intervention were directed towards primary care physicians and patients and included facilitated bone mineral density testing, patient education and patient-specific recommendations for osteoporosis treatment. The primary outcome was the implementation of appropriate osteoporosis management. RESULTS: 101 patients were allocated to intervention and 100 to control. Mean age of participants was 71.9 ± 7.2 years and 94% were women. Pharmacological treatment (alendronate, risedronate, or raloxifene) for osteoporosis was increased by 29% compared to usual care (56% [29/52] vs. 27% [16/60]; relative risk [RR] 2.09, 95% confidence interval [CI] 1.29 to 3.40). More individuals in the intervention group were taking calcium (54% [54/101] vs. 20% [20/100]; RR 2.67, 95% CI 1.74 to 4.12) and vitamin D (33% [33/101] vs. 20% [20/100]; RR 1.63, 95% CI 1.01 to 2.65). CONCLUSIONS: A multi-faceted community-based intervention improved management of osteoporosis in high risk patients compared with usual care. TRIAL REGISTRATION: This trial has been registered with clinicaltrials.gov (ID: NCT00465387).


Subject(s)
Community Health Services/methods , Osteoporosis/epidemiology , Osteoporosis/therapy , Aged , Aged, 80 and over , Community Health Services/standards , Disease Management , Female , Follow-Up Studies , Fractures, Bone/epidemiology , Fractures, Bone/etiology , Fractures, Bone/prevention & control , Humans , Male , Middle Aged , Osteoporosis/diagnosis
2.
Phys Occup Ther Pediatr ; 23(2): 45-58, 2003.
Article in English | MEDLINE | ID: mdl-12951787

ABSTRACT

The 66-item Gross Motor Function Measure (GMFM-66) requires a computer program for scoring. The primary purpose of this study was to pilot test the scoring software and examine the perceived clinical utility of the GMFM-66 as judged by 48 pediatric physical therapists. Sixty-one percent of therapists were confident in their ability to interpret the information from the computer program following one hour spent reading the tutorial and interpretation guidelines. Ninety-three percent of respondents perceived the overall clinical utility of the GMFM-66 in terms of administration, scoring and interpretation to be the same or more clinically useful than the GMFM-88.


Subject(s)
Cerebral Palsy/classification , Cerebral Palsy/physiopathology , Computer-Assisted Instruction , Disability Evaluation , Motor Skills/classification , Physical Therapy Specialty/education , Child , Cross-Sectional Studies , Educational Measurement , Humans , Outcome Assessment, Health Care
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