Journal article
The Contribution of Patient, Primary Care Physician, and Primary Care Clinic Factors to Good Bone Health Care
Permanente journal, Vol.25(1), pp.1-3
01/2021
DOI: 10.7812/TPP/20.095
PMCID: PMC8784026
PMID: 33635767
Abstract
Patient, provider, and system factors can contribute to chronic care management and outcomes. Few studies have examined these multilevel associations with osteoporosis care and outcomes. We examined how key process and structural factors at the patient, primary care physician (PCP), and primary care clinic (PCC) levels were associated with guideline concordant osteoporosis pharmacotherapy, daily calcium intake, vitamin D supplementation, and weekly exercise sessions at 52 weeks following enrollment in a cluster randomized controlled trial.
We conducted a secondary analysis of observational data from 1 site of the trial. The study sample included 1996 men and women ≥ 50 years of age at the time of recruitment following completion of a dual-energy x-ray absorptiometry (DXA) scan and who had complete data at baseline and 52 weeks. Our primary independent variable was "relationship continuity": the DXA-ordering provider was the patient's PCP. Hierarchical linear and logistic regression accounted for patient, provider, and primary care clinic characteristics.
In multivariable regression analyses, relationship continuity (ie, the PCP ordered the study DXA) was associated with higher average daily calcium intake and likelihood of vitamin D supplementation at 52 weeks. No PCP or primary care clinic factors were associated with osteoporosis care.
The relationship continuity, in which the provider ordering a DXA is the patient's PCP and therefore also presents the results of a DXA, may help to promote patient behaviors associated with good bone health.
Details
- Title: Subtitle
- The Contribution of Patient, Primary Care Physician, and Primary Care Clinic Factors to Good Bone Health Care
- Creators
- Douglas W Roblin - Kaiser PermanentePeter Cram - University of TorontoYiyue Lou - Vertex PharmaceuticalsStephanie W Edmonds - University of IowaSylvie F Hall - Bellevue Hospital CenterMichael P Jones - University of IowaKenneth G Saag - University of Alabama at BirminghamNicole C Wright - University of Alabama at BirminghamLee F Cromwell - Kaiser PermanenteBrandi E Robinson - Kaiser PermanenteFredric D Wolinsky - University of IowaPAADRN Investigators
- Resource Type
- Journal article
- Publication Details
- Permanente journal, Vol.25(1), pp.1-3
- DOI
- 10.7812/TPP/20.095
- PMID
- 33635767
- PMCID
- PMC8784026
- NLM abbreviation
- Perm J
- ISSN
- 1552-5775
- eISSN
- 1552-5775
- Grant note
- K24 AR062133 / NIAMS NIH HHS K12 HS023009 / AHRQ HHS R01 AG033035 / NIA NIH HHS
- Language
- English
- Date published
- 01/2021
- Academic Unit
- Statistics and Actuarial Science; Health Management and Policy; Biostatistics; Nursing; Public Policy Center (Archive)
- Record Identifier
- 9984283561102771
Metrics
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