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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 30 Research Studies DisplayedAdami G, Saag KG, Mudano G, Saag KG, Mudano AS
Factors associated with the contemplative stage of readiness to initiate osteoporosis treatment.
Osteoporos Int 2020 Jul;31(7):1283-90. doi: 10.1007/s00198-020-05312-4.
AHRQ-funded; HS023009.
Citation: Adami G, Saag KG, Mudano G, Saag KG, Mudano AS .
Factors associated with the contemplative stage of readiness to initiate osteoporosis treatment.
Osteoporos Int 2020 Jul;31(7):1283-90. doi: 10.1007/s00198-020-05312-4..
Keywords: Osteoporosis, Women, Shared Decision Making
Chovatiya R, Silverberg JI
Association of pemphigus and pemphigoid with osteoporosis and pathological fractures.
Researchers sought to determine whether pemphigus and bullous pemphigoid (BP) are associated with osteoporosis and fractures in the US. Subjects for this cross-sectional study included adults with pemphigus or with BP from the 2006-2012 National Emergency Department Sample. The researchers found that, when compared to BP, pemphigus was associated with higher odds of osteopenia, osteoporosis, and fractures, particularly of the ulna and radius. Patients with pemphigus or BP as well as long-term systemic corticosteroid use had the highest odds of osteoporosis and fractures. The researchers suggested that patients with these conditions may benefit from increased screening for osteoporosis and interventions to prevent fractures.
AHRQ-funded; HS023011.
Citation: Chovatiya R, Silverberg JI .
Association of pemphigus and pemphigoid with osteoporosis and pathological fractures.
Arch Dermatol Res 2020 May;312(4):263-71. doi: 10.1007/s00403-019-02010-y..
Keywords: Healthcare Cost and Utilization Project (HCUP), Osteoporosis, Injuries and Wounds, Emergency Department
Lopez-Olivo MA, des Bordes JKA, Lin H
Comparison of multimedia and printed patient education tools for patients with osteoporosis: a 6-month randomized controlled trial.
Researchers compared the efficacy of adding a multimedia patient education tool involving video modeling to a printed educational booklet on osteoporosis. Participants in the randomized controlled trial were post-menopausal women with osteoporosis. The researchers found that both multimedia and printed tools increased knowledge and decreased decisional conflict to the same extent, and neither of the educational materials proved to be better than the other. For women with limited health literacy, receiving the booklet alone was more effective in reducing decisional conflict after 6 months than the addition of the multimedia tool.
AHRQ-funded; HS019354.
Citation: Lopez-Olivo MA, des Bordes JKA, Lin H .
Comparison of multimedia and printed patient education tools for patients with osteoporosis: a 6-month randomized controlled trial.
Osteoporos Int 2020 May;31(5):857-66. doi: 10.1007/s00198-019-05210-4..
Keywords: Education: Patient and Caregiver, Osteoporosis, Chronic Conditions, Women
Shaheen MS, Silverberg JI
Association of asthma with osteopenia, osteoporosis, osteomalacia, and fractures.
Previous studies that examined the relationship between asthma, osteoporosis, and pathologic fractures found conflicting results. The objective of this study was to determine whether asthma was associated with osteopenia, osteoporosis, osteomalacia, and fractures in U.S. adults. The investigators concluded that ED visits with asthma were associated with osteopenia, osteoporosis, osteomalacia, and pathologic fractures.
Citation: Shaheen MS, Silverberg JI .
Association of asthma with osteopenia, osteoporosis, osteomalacia, and fractures.
Allergy Asthma Proc 2020 Mar 1;41(2):112-19. doi: 10.2500/aap.2020.41.190035.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Osteoporosis, Injuries and Wounds, Emergency Department
Wright NC, Melton ME, Sohail M
Race plays a role in the knowledge, attitudes, and beliefs of women with osteoporosis.
This study examined racial disparities in knowledge of osteoporosis among women aged 65 and over with osteoporosis. Focus groups were created with a total of 48 women (36 white, 12 African American) enrolled. A knowledge scale called “Osteoporosis & You” was used to compare scores. White women had a mean score of 7.8 versus African American women who scored a mean of 6.6 out of 10 on the scale. The “powerful others” domain was significantly higher among African Americans versus white women as well. These racial differences can impact bone health and indicated a need to improve education and awareness about osteoporosis among African American women.
AHRQ-funded; HS023009.
Citation: Wright NC, Melton ME, Sohail M .
Race plays a role in the knowledge, attitudes, and beliefs of women with osteoporosis.
J Racial Ethn Health Disparities 2019 Aug;6(4):707-18. doi: 10.1007/s40615-019-00569-w..
Keywords: Disparities, Racial and Ethnic Minorities, Osteoporosis, Women
Fink HA, MacDonald R, Forte ML
Long-term drug therapy and drug discontinuations and holidays for osteoporosis fracture prevention: a systematic review.
Optimal long-term osteoporosis drug treatment (ODT) is uncertain. The purpose of this study was to summarize the effects of long-term ODT and ODT discontinuation and holidays. The investigators concluded that: long-term alendronate and zoledronic acid therapies reduce fracture risk in women with osteoporosis; long-term bisphosphonate treatment may increase risk for rare adverse events, and continuing treatment beyond 3 to 5 years may reduce risk for vertebral fractures; and long-term hormone therapy reduces hip fracture risks but has serious harms.
AHRQ-funded; 290201500008I.
Citation: Fink HA, MacDonald R, Forte ML .
Long-term drug therapy and drug discontinuations and holidays for osteoporosis fracture prevention: a systematic review.
Ann Intern Med 2019 Jul 2;171(1):37-50. doi: 10.7326/m19-0533.
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Keywords: Evidence-Based Practice, Injuries and Wounds, Medication, Osteoporosis, Outcomes, Patient-Centered Outcomes Research, Prevention
Fan T, Duffy M
Screening for osteoporosis to prevent fractures.
This case study provides case questions and answers related to the U.S. Preventive Services Task Force recommendations on screening for osteoporosis to prevent fractures. It is part of the “Putting Prevention into Practice” series.
AHRQ-authored.
Citation: Fan T, Duffy M .
Screening for osteoporosis to prevent fractures.
Am Fam Physician 2018 Nov 15;98(10):593-94..
Keywords: Case Study, Injuries and Wounds, Osteoporosis, Prevention, Screening
Hall SF, Wright NC, Wolinsky FD
The prevalence of overtreatment of osteoporosis: results from the PAADRN trial.
There is a robust body of literature addressing undertreatment in osteoporosis, but limited data addressing overtreatment. In this study, the investigators sought to understand overtreatment as this understanding is important to minimizing harm and decrease costs. The investigators found that in their sample of older adults, overuse of osteoporosis pharmacotherapy was only 8.1%. Nevertheless, they concluded, overtreatment exposed patients to possible risk with negligible chance of benefit and should be minimized.
AHRQ-funded; HS023009.
Citation: Hall SF, Wright NC, Wolinsky FD .
The prevalence of overtreatment of osteoporosis: results from the PAADRN trial.
Arch Osteoporos 2018 Sep 28;13(1):103. doi: 10.1007/s11657-018-0517-6..
Keywords: Osteoporosis, Shared Decision Making, Medication, Elderly, Patient-Centered Healthcare, Patient and Family Engagement, Care Management
Danila MI, Outman RC, Rahn EJ
Evaluation of a multimodal, direct-to-patient educational intervention targeting barriers to osteoporosis care: a randomized clinical trial.
Osteoporosis treatment rates are declining, even among those with past fractures. Novel, low-cost approaches are needed to improve osteoporosis care. In this study, the investigators conducted a parallel group, controlled, randomized clinical trial evaluating a behavioral intervention for improving osteoporosis medication use. They found that the primary study outcome was self-report of osteoporosis medication use at 6 months. Other outcomes included calcium and vitamin D supplementation, bone mineral density (BMD) testing, readiness for behavioral change, and barriers to treatment.
AHRQ-funded; HS023009.
Citation: Danila MI, Outman RC, Rahn EJ .
Evaluation of a multimodal, direct-to-patient educational intervention targeting barriers to osteoporosis care: a randomized clinical trial.
J Bone Miner Res 2018 May;33(5):763-72. doi: 10.1002/jbmr.3395..
Keywords: Care Management, Education: Patient and Caregiver, Elderly, Healthcare Delivery, Osteoporosis
Noel SE, Mangano KM, Griffith JL
Prevalence of osteoporosis and low bone mass among Puerto Rican older adults.
The authors aimed to determine the prevalence of osteoporosis and low bone mass (LBM) among 953 Puerto Rican adults, aged 47 to 79 years and living on the US mainland, using data from the Boston Puerto Rican Osteoporosis Study (BPROS). They found that the overall prevalence of osteoporosis and LBM were 10.5% and 43.3% for participants in the BPROS, respectively. They conclude that their findings indicate a need to understand specific factors contributing to osteoporosis in Puerto Rican adults, particularly younger men, in order to provide important information to guide the development of culturally- and linguistically-tailored interventions to improve bone health in this understudied and high-risk population.
AHRQ-funded; HS023009.
Citation: Noel SE, Mangano KM, Griffith JL .
Prevalence of osteoporosis and low bone mass among Puerto Rican older adults.
J Bone Miner Res 2018 Mar;33(3):396-403. doi: 10.1002/jbmr.3315..
Keywords: Osteoporosis, Elderly, Racial and Ethnic Minorities
Lopez-Olivo MA, Ingleshwar A, Volk RJ
Development and pilot testing of multimedia patient education tools for patients with knee osteoarthritis, osteoporosis, and rheumatoid arthritis.
Researched developed multimedia educational tools that incorporated videos to help patients understand their chronic diseases including osteoporosis, osteoarthritis, and rheumatoid arthritis. Tools were developed in English and Spanish. A total of 60 patients (20 per disease) were recruited to see the videos and were interviewed after all. All participants gave them a favorable rating and felt it helped them understand the disease, the importance of taking their medications, and seeing their doctor regularly. They found the videos and accompanying materials easy to use and easy to understand.
AHRQ-funded; HS019354.
Citation: Lopez-Olivo MA, Ingleshwar A, Volk RJ .
Development and pilot testing of multimedia patient education tools for patients with knee osteoarthritis, osteoporosis, and rheumatoid arthritis.
Arthritis Care Res 2018 Feb;70(2):213-20. doi: 10.1002/acr.23271..
Keywords: Arthritis, Chronic Conditions, Education: Patient and Caregiver, Osteoporosis, Health Literacy
Cram P, Saag KG, Lou Y
Racial differences and disparities in osteoporosis-related bone health: results from the PAADRN randomized controlled trial.
The researchers examined whether providing dual-energy x-ray absorptiometry (DXA) test results directly to patients might reduce or eliminate racial differences in osteoporosis-related health care. They found that black women were still less likely to know their actual DXA result and less likely to be on guideline-concordant therapy, but black women had greater patient activation.
AHRQ-funded; HS023009.
Citation: Cram P, Saag KG, Lou Y .
Racial differences and disparities in osteoporosis-related bone health: results from the PAADRN randomized controlled trial.
Med Care 2017 Jun;55(6):561-68. doi: 10.1097/mlr.0000000000000718.
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Keywords: Racial and Ethnic Minorities, Disparities, Osteoporosis, Health Status
Wright NC, Delzell ES, Smith WK
Improving medical record retrieval for validation studies in Medicare data.
The purpose of the study is to describe medical record retrieval for a study validating claims-based algorithms used to identify seven adverse events of special interest (AESI) in a Medicare population. It concluded that the national medical record validation study of claims-based algorithms produced a modest retrieval rate. The medical record procedures outlined in this paper could have led to the improved retrieval from the researchers’ previous medical record retrieval study.
AHRQ-funded; HS023009.
Citation: Wright NC, Delzell ES, Smith WK .
Improving medical record retrieval for validation studies in Medicare data.
Pharmacoepidemiol Drug Saf 2017 Apr;26(4):393-401. doi: 10.1002/pds.4131.
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Keywords: Medicare, Electronic Health Records (EHRs), Osteoporosis, Elderly
Wright NC, Saag KG, Dawson-Hughes B
The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA.
This study evaluated the prevalence of osteoporosis using the osteoporosis diagnostic criteria developed by the National Bone Health Alliance (NBHA), which includes qualified fractures, FRAX score in addition to bone mineral density (BMD). The study found that 16% of men and 29.9% of women 50+ have osteoporosis based on the NBHA diagnostic criteria.
AHRQ-funded; HS023009.
Citation: Wright NC, Saag KG, Dawson-Hughes B .
The impact of the new National Bone Health Alliance (NBHA) diagnostic criteria on the prevalence of osteoporosis in the USA.
Osteoporos Int 2017 Apr;28(4):1225-32. doi: 10.1007/s00198-016-3865-3..
Keywords: Diagnostic Safety and Quality, Injuries and Wounds, Osteoporosis
Kathuria P, Gordon KB, Silverberg JI
Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures.
This study investigated whether psoriasis (Pso) and psoriatic arthritis (PsA) are associated with osteoporosis and fractures in US adults. Using records of 183,725 persons with Pso and 28,765 with PsA from the 2006-2012 National Emergency Department Sample, including 20 percent of the emergency care visits throughout the United States, it found that Pso and PsA were associated with osteopenia, osteoporosis, ankylosing spondylitis, and pathologic fractures.
AHRQ-funded; HS023011.
Citation: Kathuria P, Gordon KB, Silverberg JI .
Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures.
J Am Acad Dermatol 2017 Mar 14;76(6):1045-53.e3. doi: 10.1016/j.jaad.2016.11.046.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Osteoporosis, Injuries and Wounds, Arthritis
Franklin PD, Miozzari H, Christofilopoulos P
Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.
The researchers compared preoperative patient and clinical characteristics from two large cohorts who underwent either total knee (TKA) or hip (THA) arthroplasty, one in Switzerland, the other in the US. They found substantial differences between US and Swiss cohorts in pre-operative patient characteristics and pain levels, which has potentially important implications for cross-cultural comparison of TKA/THA outcomes.
AHRQ-funded; HS018910.
Citation: Franklin PD, Miozzari H, Christofilopoulos P .
Important patient characteristics differ prior to total knee arthroplasty and total hip arthroplasty between Switzerland and the United States.
BMC Musculoskelet Disord 2017 Jan 11;18(1):14. doi: 10.1186/s12891-016-1372-5.
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Keywords: Surgery, Pain, Patient-Centered Outcomes Research, Osteoporosis, Arthritis
Goodwin JS, Zhou J, Kuo YF
Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer.
The researchers compared the risk of jaw osteonecrosis after intravenous (IV) bisphosphonate administered to patients with cancer vs patients without cancer. During follow-up, 40 (0.42 percent) out of 9,482 patients with cancer developed probable jaw osteonecrosis compared with 8 (0.05 percent) out of 16,046 patients without cancer.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Zhou J, Kuo YF .
Risk of jaw osteonecrosis after intravenous bisphosphonates in cancer patients and patients without cancer.
Mayo Clin Proc 2017 Jan;92(1):106-13. doi: 10.1016/j.mayocp.2016.09.015.
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Keywords: Cancer, Osteoporosis, Risk, Medication, Patient-Centered Outcomes Research
Garcia I, Chiodo V, Ma Y
Evidence of altered matrix composition in iliac crest biopsies from patients with idiopathic juvenile osteoporosis.
The goal of this study is to describe idiopathic juvenile osteoporosis (IJO)bone composition. It concluded that IJO bone, similar to post-menopausal osteoporosis (PMO) bone, had elevated collagen maturity relative to its age-matched controls. This emphasizes the importance of the collagen matrix for bone health. IJO bone differed from PMO bone as IJO bone contains more recently formed mineral than age-matched controls.
AHRQ-funded; HS021734.
Citation: Garcia I, Chiodo V, Ma Y .
Evidence of altered matrix composition in iliac crest biopsies from patients with idiopathic juvenile osteoporosis.
Connect Tissue Res 2016;57(1):28-37. doi: 10.3109/03008207.2015.1088531.
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Keywords: Osteoporosis, Children/Adolescents, Children/Adolescents
Cram P, Wolinsky FD, Lou Y
Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.
In a clinical trial of 7749 patients, the researchers tested whether usual care augmented by a tailored patient-activation DXA result letter accompanied by an educational brochure would improve guideline-concordant pharmacological treatment compared to usual care only. They found that treatment rates did not improve.
AHRQ-funded; HS023009.
Citation: Cram P, Wolinsky FD, Lou Y .
Patient-activation and guideline-concordant pharmacological treatment after bone density testing: the PAADRN randomized controlled trial.
Osteoporos Int 2016 Dec;27(12):3513-24. doi: 10.1007/s00198-016-3681-9.
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Keywords: Education: Patient and Caregiver, Guidelines, Medication, Osteoporosis, Patient and Family Engagement
Edmonds SW, Cram P, Lou Y
Effects of a DXA result letter on satisfaction, quality of life, and osteoporosis knowledge: a randomized controlled trial.
This study tested whether a tailored dual energy x-ray absorptiometry (DXA) test result letter and an accompanying educational bone-health brochure affected patient satisfaction, quality of life (QOL), or osteoporosis (OP) knowledge. It found that a tailored DXA result letter and bone-health educational brochure sent to patients improved patient satisfaction with bone-related health care. There were no differences between the intervention and usual care groups in QOL or OP knowledge.
AHRQ-funded; HS023009.
Citation: Edmonds SW, Cram P, Lou Y .
Effects of a DXA result letter on satisfaction, quality of life, and osteoporosis knowledge: a randomized controlled trial.
BMC Musculoskelet Disord 2016 Aug 26;17(1):369. doi: 10.1186/s12891-016-1227-0.
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Keywords: Education: Patient and Caregiver, Osteoporosis, Patient Experience, Quality of Life
Fenton JJ, Robbins JA, Amarnath AL
Osteoporosis overtreatment in a regional health care system.
The researchers estimated the frequency of osteoporosis overtreatment in a regional health care system where DXA reports routinely include T scores for anatomic sites (e.g., lateral lumbar spine) that the International Society for Clinical Densitometry does not recommend for osteoporosis diagnosis. They found that two-thirds of new osteoporosis drug prescriptions were potentially inappropriate.
AHRQ-funded; HS022236.
Citation: Fenton JJ, Robbins JA, Amarnath AL .
Osteoporosis overtreatment in a regional health care system.
JAMA Intern Med 2016 Mar;176(3):391-3. doi: 10.1001/jamainternmed.2015.6020.
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Keywords: Shared Decision Making, Diagnostic Safety and Quality, Medication, Osteoporosis
LaFleur J, Rillamas-Sun E, Colon-Emeric CS
Fracture rates and bone density among postmenopausal veteran and non-veteran women from the Women's Health Initiative.
The authors compared fracture rates and bone mineral density for veterans and non-veterans using Women's Health Initiative data. They found that veterans had higher 10-year probabilities for any major fracture and hip fracture compared with non-veterans, but that risk of fracture at other anatomic sites did not differ by veteran status. They concluded that female veterans had an increased hip fracture rate not explained by differences in well-recognized fracture risk factors.
AHRQ-funded; HS018582.
Citation: LaFleur J, Rillamas-Sun E, Colon-Emeric CS .
Fracture rates and bone density among postmenopausal veteran and non-veteran women from the Women's Health Initiative.
Gerontologist 2016 Feb;56 Suppl 1:S78-90. doi: 10.1093/geront/gnv677.
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Keywords: Elderly, Injuries and Wounds, Osteoporosis, Women
Amarnath AL, Franks P, Robbins JA
Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study.
The researchers aimed to determine the extent to which dual-energy x-ray absorptiometry (DXA) screening is used in accordance with USPSTF recommendations within a regional health system. They concluded that DXA screening was underused in women at increased fracture risk, including women age 65 and over. Meanwhile, DXA screening was common among women at low fracture risk, such as younger women without osteoporosis risk factors.
AHRQ-funded; HS022236.
Citation: Amarnath AL, Franks P, Robbins JA .
Underuse and overuse of osteoporosis screening in a regional health system: a retrospective cohort study.
J Gen Intern Med 2015 Dec;30(12):1733-40. doi: 10.1007/s11606-015-3349-8.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Osteoporosis, Healthcare Utilization, Risk
Crandall CJ, Hovey KM, Andrews CA
Bone mineral density as a predictor of subsequent wrist fractures: findings from the Women's Health Initiative Study.
This paper's objective was to examine associations between the Fracture Risk Assessment Tool (FRAX)-predicted risk of major osteoporotic fracture (MOF), bone mineral density (BMD), BMD change, and wrist fracture. Results showed that lumbar spine and femoral neck BMDs were associated with incident wrist fracture, but the FRAX threshold recommended to identify screening candidates did not identify the majority of women who subsequently experienced wrist fracture.
AHRQ-funded; HS023009.
Citation: Crandall CJ, Hovey KM, Andrews CA .
Bone mineral density as a predictor of subsequent wrist fractures: findings from the Women's Health Initiative Study.
J Clin Endocrinol Metab 2015 Nov;100(11):4315-24. doi: 10.1210/jc.2015-2568.
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Keywords: Injuries and Wounds, Osteoporosis, Risk, Women
Hernandez I, Zhang Y
Comparing clinical and economic outcomes of biologic and conventional medications in postmenopausal women with osteoporosis.
This study compared clinical and economic outcomes between teriparatide (monthly costs $1120) and bisphosphonates (monthly costs $14) among postmenopausal women with osteoporosis. It found that teriparatide users had higher risk of fracture and higher costs, compared with similar bisphosphonates users. The hazard ratios of fracture for teriparatide relative to bisphosphonates ranged from 1.37 to 2.12, depending on methods.
AHRQ-funded; HS018657.
Citation: Hernandez I, Zhang Y .
Comparing clinical and economic outcomes of biologic and conventional medications in postmenopausal women with osteoporosis.
J Eval Clin Pract 2015 Oct;21(5):840-7. doi: 10.1111/jep.12389.
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Keywords: Medication, Women, Osteoporosis, Healthcare Costs