Diet and exercise changes following bone densitometry in the Patient Activation After DXA Result Notification (PAADRN) study

Douglas Roblin; Peter Cram; Yiyue Lou; Stephanie Edmonds; Sylvie Hall; Michael Jones; Kenneth Saag; Nicole Wright; Fredric Wolinsky

doi:10.1007/s11657-017-0402-8

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Diet and exercise changes following bone densitometry in the Patient Activation After DXA Result Notification (PAADRN) study

Journal article

Peer reviewed

Diet and exercise changes following bone densitometry in the Patient Activation After DXA Result Notification (PAADRN) study

Douglas Roblin, Peter Cram, Yiyue Lou, Stephanie Edmonds, Sylvie Hall, Michael Jones, Kenneth Saag, Nicole Wright and Fredric Wolinsky

Archives of Osteoporosis, Vol.13(1), pp.1-11

12/2018

DOI: 10.1007/s11657-017-0402-8

PMID: 29307094

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https://www.ncbi.nlm.nih.gov/pmc/articles/7409367View

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Abstract

Calcium and vitamin D intake and exercise are suboptimal among older adults. Following bone densitometry, a letter communicating individualized fracture risk accompanied by an educational brochure improved participants’ lifestyle—but no more than existing communication strategies—over 52 weeks. Simple communication strategies are insufficient for achieving optimal levels of bone health behaviors.The Patient Activation After DXA Result Notification (PAADRN) study was designed to evaluate whether a letter with individualized fracture risk and an educational brochure mailed to patients soon after their DXA might improve bone health behaviors (daily calcium intake, vitamin D supplementation, and weekly exercise sessions) compared to slower, less individualized communication characterizing usual care.Participants ≥ 50 years were recruited, at three sites, following their DXA and randomized with 1:1 allocation to intervention and control (usual care only) groups. Data were collected at enrollment interview and by phone survey at 12 and 52 weeks thereafter. Intention-to-treat analyses were conducted on 7749 of the 20,397 eligible participants who enrolled. Changes in bone health behaviors were compared within and between study groups. Average treatment effects and heterogeneity of treatment effects were estimated with multivariable linear and logistic regression models.In unadjusted analyses, calcium intake, vitamin D supplementation, and weekly exercise sessions increased significantly over 52 weeks within both the intervention and control groups (all p < 0.001). In unadjusted analyses and multivariable models, increases in each behavior did not significantly differ between the intervention and control groups. Intervention group participants with a > 20% 10-year fracture risk at enrollment did, however, have a significantly greater increase in calcium intake compared to other study participants (p = 0.031).Bone health behaviors improved, on average, over 52 weeks among all participants following a DXA. Receipt of the PAADRN letter and educational brochure did not directly improve bone health behaviors compared to usual care.The Patient Activation after DXA Result Notification (PAADRN) Study is registered at ClinicalTrials.Gov: NCT01507662, https://clinicaltrials.gov/ct2/show/NCT01507662

Osteoporosis

Exercise

Orthopedics

Endocrinology

Medicine & Public Health

Diet

Patient-provider communication

Fracture risk

Details

Title: Subtitle: Diet and exercise changes following bone densitometry in the Patient Activation After DXA Result Notification (PAADRN) study
Creators: Douglas Roblin - 0000 0000 9957 7758 grid.280062.e Center for Clinical and Outcomes Research, Kaiser Permanente Atlanta GA USA
Peter Cram - 0000 0004 0474 0428 grid.231844.8 Division of General Internal Medicine and Geriatrics Mt. Sinai/UHN Hospitals Toronto Canada
Yiyue Lou - 0000 0004 1936 8294 grid.214572.7 Department of Biostatistics University of Iowa College of Public Health Iowa City IA USA
Stephanie Edmonds - 0000 0004 1936 8294 grid.214572.7 College of Nursing University of Iowa Iowa City IA USA
Sylvie Hall - 0000 0004 1936 8294 grid.214572.7 College of Nursing University of Iowa Iowa City IA USA
Michael Jones - 0000 0004 1936 8294 grid.214572.7 Department of Biostatistics University of Iowa College of Public Health Iowa City IA USA
Kenneth Saag - 0000000106344187 grid.265892.2 Division of Clinical Immunology and Rheumatology, Department of Medicine University of Alabama at Birmingham Birmingham AL USA
Nicole Wright - 0000000106344187 grid.265892.2 Department of Epidemiology University of Alabama at Birmingham Birmingham AL USA
Fredric Wolinsky - 0000 0004 1936 8294 grid.214572.7 Department of Health Management and Policy, College of Public Health University of Iowa Iowa City IA USA
Contributors: PAADRN Investigators (Author)
Resource Type: Journal article
Publication Details: Archives of Osteoporosis, Vol.13(1), pp.1-11
DOI: 10.1007/s11657-017-0402-8
PMID: 29307094
NLM abbreviation: Arch Osteoporos
ISSN: 1862-3522
eISSN: 1862-3514
Publisher: Springer London; London
Language: English
Date published: 12/2018
Academic Unit: Statistics and Actuarial Science; Health Management and Policy; Biostatistics; Nursing; Public Policy Center (Archive); Internal Medicine
Record Identifier: 9983985959502771

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