Optimizing Fracture Care Outcomes
- A Comparative Effectiveness Approach
Fractures lead to significant morbidity, mortality, and costs among the elderly. As the baby-boomer generation ages, it is critical that fracture prevention and effective treatment be undertaken aggressively, especially among people who have already had at least one fracture.
The broad objective of this Project is to identify the most effective approaches to post-fracture care with a focus on secondary fracture prevention. While there has been much interest in improving post-fracture bisphosphonate use, the incidence of second fracture is greatest early after the first fracture. We lack evidence regarding which post fracture practices will reduce both short- and long-term secondary fracture incidents and on which interventions that might mitigate poor outcomes among the sub-group of elders who do not survive long enough to benefit from osteoporosis treatment.
These knowledge gaps are being addressed by evaluating alternative post-fracture care strategies. By studying the large national population of fracture patients cared for in diverse settings, we will be able to identify correlates of safe, effective post-fracture care. A multidisciplinary team is characterizing the impact of variation in care patterns on secondary fracture, mortality, and health care costs. By evaluating the impact of alternative post-fracture care strategies, the long-term health and economic consequences of specific interventions in post-fracture care can be more fully understood and communicated to policy makers.
Julie Bynum, MD, MS – Project Leader
Anna Tosteson, ScD, - Project Leader
John-Erik Bell, MD, MS
Rob Cantu, MD, MS
Christine McDonough, PT, PhD
Jeff Munson, MD, MSCE
Osteoporosis International , 2016;27(7): 2207-1510.1007/s00198-016-3542-6 Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures
Physical Therapy, 2017;97(3): 280-910.1093/ptj/pzx009 Patterns of Prescription Drug Use Before and After Fragility Fracture
JAMA Internal Medicine, 2016;176(10): 1531-810.1001/jamainternmed.2016.4814