With the aging of the world population, osteoporosis and fragility fractures have become global public health concerns. It has been estimated the population of people ≥60 years of age will increase from 229 million (16.2%) in 2017 to 479 million (35.1%) by 2050 in China. Because age is an important predictor of osteoporosis and fragility fracture, the incidence of fragility fracture has increased dramatically in China over the past decades. Timely treatment of osteoporosis is an effective way to decrease additional fracture risk among patients with fragility fractures, but anti-osteoporosis treatment rate is relatively low in China. Effective fracture prevention intervention is urgently needed in China. As a potential way to achieve effective risk communication, shared decision-making allows patients to be active participants in the management of osteoporosis. The investigators designed a multifaceted intervention, which was named as "Precise Education + Shared Decision-Making" program for the secondary prevention of fragility fractures based on behavioral theories, and assessed the effectiveness for fracture prevention using a pilot cluster randomized controlled trial among several hospitals in China. The aim of this pilot study is to test the acceptability and feasibility as well as preliminary efficacy of this program in patients with fragility fractures.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
50
The multicomponent intervention elements include education for clinicians and patients as well as a shared decision-making program among clinicians and patients. A shared decision-making booklet and a mobile application will be used to promote osteoporosis management and fracture practice.
The Second Affiliated Hospital of Hunan University of Chinese Medicine
Changsha, China
RECRUITINGDongguan Eighth People's Hospital
Dongguan, China
RECRUITINGThird Affiliated Hospital, Sun Yat-sen University
Guangzhou, China
RECRUITINGSir Run Run Shaw Hospital, Zhejiang University School of Medicine
Hangzhou, China
RECRUITINGThe First People's Hospital of Hefei
Hefei, China
RECRUITINGLonggang Orthopedics Hospital of Shenzhen
Shenzhen, China
RECRUITINGThe Third People's Hospital of Longgang District Shenzhen
Shenzhen, China
RECRUITINGTrial feasibility - Recruitment
Number or N (%) participants recruited within 3 months of trial initiation at each centre.
Time frame: 3 months
Trial feasibility - Acceptability of the multicomponent program component
Participants will be asked to evaluate the program with a questionnaire with questions about frequency, length, content, delivery, and duration of the booklet and the mobile application using a 5-point Likert scale.
Time frame: 30 days after study recruitment
Trial feasibility - Acceptability of the shared decision-making process
Both clinicians and patients will be asked to evaluate the shared decision-making process once they completed it. A survey will be administered to evaluate the content and comprehension of the program using a 5-point Likert scale.
Time frame: 7 days after study recruitment
Trial feasibility - Retention
The retention rates will be assessed as the 30-day follow-up rate.
Time frame: 30 days after study recruitment
Anti-osteoporosis treatment rate
The patients will be followed up and asked whether they accept any anti-osteoporosis medication.
Time frame: 1 month follow-up; 3 month follow-up; 6 month follow-up; 12 month follow-up; 24 month follow-up
Shared decision-making process
Standardized questionnaires will be used to evaluated the shared decision-making process.
Time frame: 7 days after study recruitment
Bone mineral density test
The patients will be followed up and asked whether they accept bone mineral density test.
Time frame: 3 month follow-up; 6 month follow-up; 12 month follow-up; 24 month follow-up
Adherence of anti-osteoporosis medication
Adherence of anti-osteoporosis medication will be assessed with medication possession ratio and self-reported question.
Time frame: 1 month follow-up; 3 month follow-up; 6 month follow-up; 12 month follow-up; 24 month follow-up
Diagnosis, education, and follow-up practice of osteoporosis
The patients will be followed up with questionnaires about diagnosis, education, and follow-up of osteoporosis.
Time frame: 1 month follow-up; 3 month follow-up; 6 month follow-up; 12 month follow-up; 24 month follow-up
Refracture
The patients will be followed up and asked whether they have refracture.
Time frame: 1 month follow-up; 3 month follow-up; 6 month follow-up; 12 month follow-up; 24 month follow-up
Survival
The patients will be followed up about their survival status.
Time frame: 1 month follow-up; 3 month follow-up; 6 month follow-up; 12 month follow-up; 24 month follow-up
Patients' knowledge and attitude about osteoporosis and fragility fracture
Patients' knowledge and attitude about osteoporosis and fragility fracture will be evaluated with standardized questionnaires.
Time frame: baseline; 1 month follow-up; 6 month follow-up
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