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Lin-Stephens S. Visual stimuli in narrative-based interventions for adult anxiety: a systematic review. ANXIETY STRESS AND COPING 2020; 33:281-298. [DOI: 10.1080/10615806.2020.1734575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Serene Lin-Stephens
- Faculty of Medicine and Health, Discipline of Rehabilitation Counselling, The University of Sydney, Sydney, Australia
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Danila MI, Outman RC, Rahn EJ, Mudano AS, Redden DT, Li P, Allison JJ, Anderson FA, Wyman A, Greenspan SL, LaCroix AZ, Nieves JW, Silverman SL, Siris ES, Watts NB, Miller MJ, Curtis JR, Warriner AH, Wright NC, Saag KG. Evaluation of a Multimodal, Direct-to-Patient Educational Intervention Targeting Barriers to Osteoporosis Care: A Randomized Clinical Trial. J Bone Miner Res 2018; 33:763-772. [PMID: 29377378 PMCID: PMC6016546 DOI: 10.1002/jbmr.3395] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 12/14/2017] [Accepted: 01/10/2018] [Indexed: 11/06/2022]
Abstract
Osteoporosis treatment rates are declining, even among those with past fractures. Novel, low-cost approaches are needed to improve osteoporosis care. We conducted a parallel group, controlled, randomized clinical trial evaluating a behavioral intervention for improving osteoporosis medication use. A total of 2684 women with self-reported fracture history after age 45 years not using osteoporosis therapy from US Global Longitudinal Study of Osteoporosis in Women (GLOW) sites were randomized 1:1 to receive a multimodal, tailored, direct-to-patient, video intervention versus usual care. 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. In intent-to-treat analyses, there were no significant differences between groups (intervention versus control) in osteoporosis medication use (11.7% versus 11.4%, p = 0.8), calcium supplementation (31.8% versus 32.6%, p = 0.7), vitamin D intake (41.3% versus 41.9%, p = 0.8), or BMD testing (61.8% versus 57.1%, p = 0.2). In the intervention group, fewer women were in the precontemplative stage of behavior change, more women reported seeing their primary care provider, had concerns regarding osteonecrosis of the jaw, and difficulty in taking/remembering to take osteoporosis medications. We found differences in BMD testing among the subgroup of women with no prior osteoporosis treatment, those who provided contact information, and those with no past BMD testing. In per protocol analyses, women with appreciable exposure to the online intervention (n = 257) were more likely to start nonbisphosphonates (odds ratio [OR] = 2.70; 95% confidence interval [CI] 1.26-5.79) compared with the usual care group. Although our intervention did not increase the use of osteoporosis therapy at 6 months, it increased nonbisphosphonate medication use and BMD testing in select subgroups, shifted participants' readiness for behavior change, and altered perceptions of barriers to osteoporosis treatment. Achieving changes in osteoporosis care using patient activation approaches alone is challenging. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Maria I Danila
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ryan C Outman
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Amy S Mudano
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - David T Redden
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Peng Li
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Fred A Anderson
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Allison Wyman
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Andrea Z LaCroix
- Group Health Cooperative, Seattle, WA, USA.,University of California San Diego, La Jolla, CA, USA
| | | | | | - Ethel S Siris
- Columbia University Medical Center, New York, NY, USA
| | - Nelson B Watts
- Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA
| | - Michael J Miller
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, College Station, TX, USA
| | | | - Amy H Warriner
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Kenneth G Saag
- University of Alabama at Birmingham, Birmingham, AL, USA
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Winston K, Grendarova P, Rabi D. Video-based patient decision aids: A scoping review. PATIENT EDUCATION AND COUNSELING 2018; 101:558-578. [PMID: 29102063 DOI: 10.1016/j.pec.2017.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/06/2017] [Accepted: 10/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. METHOD The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted. RESULTS 488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase. CONCLUSION Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations. PRACTICE IMPLICATIONS Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids.
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Affiliation(s)
- Karin Winston
- Alberta Children's Hospital, 2800 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada.
| | - Petra Grendarova
- University of Calgary, Division of Radiation Oncology, Calgary, Canada
| | - Doreen Rabi
- University of Calgary, Department of Medicine, Calgary, Canada
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Danila MI, Outman RC, Rahn EJ, Mudano AS, Thomas TF, Redden DT, Allison JJ, Anderson FA, Anderson JP, Cram PM, Curtis JR, Fraenkel L, Greenspan SL, LaCroix AZ, Majumdar SR, Miller MJ, Nieves JW, Safford MM, Silverman SL, Siris ES, Solomon DH, Warriner AH, Watts NB, Yood RA, Saag KG. A multi-modal intervention for Activating Patients at Risk for Osteoporosis (APROPOS): Rationale, design, and uptake of online study intervention material. Contemp Clin Trials Commun 2016; 4:14-24. [PMID: 27453960 PMCID: PMC4955389 DOI: 10.1016/j.conctc.2016.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/09/2016] [Accepted: 06/22/2016] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To develop an innovative and effective educational intervention to inform patients about the need for osteoporosis treatment and to determine factors associated with its online uptake. METHODS Postmenopausal women with a prior fracture and not currently using osteoporosis therapy were eligible to be included in the Activating Patients at Risk for OsteoPOroSis (APROPOS). Four nominal groups with a total of 18 racially/ethnically diverse women identified osteoporosis treatment barriers. We used the Information, Motivation, Behavior Skills conceptual model to develop a direct-to-patient intervention to mitigate potentially modifiable barriers to osteoporosis therapy. The intervention included videos tailored by participants' race/ethnicity and their survey responses: ranked barriers to osteoporosis treatment, deduced barriers to treatment, readiness to behavior change, and osteoporosis treatment history. Videos consisted of "storytelling" narratives, based on osteoporosis patient experiences and portrayed by actresses of patient-identified race/ethnicity. We also delivered personalized brief phone calls followed by an interactive voice-response phone messages aimed to promote uptake of the videos. RESULTS To address the factors associated with online intervention uptake, we focused on participants assigned to the intervention arm (n = 1342). These participants were 92.9% Caucasian, with a mean (SD) age 74.9 (8.0) years and the majority (77.7%) had some college education. Preference for natural treatments was the barrier ranked #1 by most (n = 130; 27%), while concern about osteonecrosis of the jaw was the most frequently reported barrier (at any level; n = 322; 67%). Overall, 28.1% (n = 377) of participants in the intervention group accessed the videos online. After adjusting for relevant covariates, the participants who provided an email address had 6.07 (95% CI 4.53-8.14) higher adjusted odds of accessing their online videos compared to those who did not. CONCLUSION We developed and implemented a novel tailored multi-modal intervention to improve initiation of osteoporosis therapy. An email address provided on the survey was the most important factor independently associated with accessing the intervention online. The design and uptake of this intervention may have implications for future studies in osteoporosis or other chronic diseases.
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Affiliation(s)
| | - Ryan C. Outman
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Amy S. Mudano
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Jeroan J. Allison
- University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Fred A. Anderson
- University of Massachusetts Medical School, Worcester, MA 01655, USA
| | | | | | | | | | | | - Andrea Z. LaCroix
- Group Health Cooperative, Seattle, WA 98112, USA
- University of California San Diego, La Jolla, CA 92093, USA
| | | | - Michael J. Miller
- The University of Oklahoma Health Sciences Center, Tulsa, OK 74135, USA
| | | | - Monika M. Safford
- University of Alabama at Birmingham, Birmingham, AL, USA
- Weill Cornell Medical Center, New York, NY 10065, USA
| | | | - Ethel S. Siris
- Columbia University Medical Center, New York, NY 10032, USA
| | | | | | - Nelson B. Watts
- Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH 45236, USA
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Mazziotti G, Formenti AM, Adler RA, Bilezikian JP, Grossman A, Sbardella E, Minisola S, Giustina A. Glucocorticoid-induced osteoporosis: pathophysiological role of GH/IGF-I and PTH/VITAMIN D axes, treatment options and guidelines. Endocrine 2016; 54:603-611. [PMID: 27766553 DOI: 10.1007/s12020-016-1146-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/06/2016] [Indexed: 01/29/2023]
Abstract
Glucocorticoid-induced osteoporosis is the most frequent form of secondary osteoporosis caused by chronic exposure to glucocorticoid excess. Pathogenesis of glucocorticoid-induced osteoporosis is multifactorial including direct effects of glucocorticoids on bone cells and indirect effects of glucocorticoids on several neuroendocrine and metabolic pathways. Fragility fractures occur early in glucocorticoid-induced osteoporosis and anti-osteoporotic drugs along with calcium and vitamin D should be started soon after exposure to glucocorticoid excess. This paper summarizes some of the main topics discussed during the 9th Glucocorticoid-Induced Osteoporosis Meeting (Rome, April 2016) with a specific focus on the role of growth hormone/insulin-like growth factor-1 and parathyroid hormone/vitamin D axes in the pathogenesis of glucocorticoid-induced osteoporosis and the controversial aspects concerning therapeutic approach to skeletal fragility in this clinical setting.
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Affiliation(s)
| | | | - Robert A Adler
- McGuire Veterans Affairs Medical Center, Virginia Commonwealth University School of Medicine Richmond, Virginia, USA
| | - John P Bilezikian
- Department of Medicine Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ashley Grossman
- Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, OX3 7LE, UK
| | - Emilia Sbardella
- Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, OX3 7LE, UK
| | - Salvatore Minisola
- Department of Internal Medicine and Medical Disciplines "Sapienza" Rome University, Rome, Italy
| | - Andrea Giustina
- Chair of Endocrinology, University of Brescia, Brescia, Italy.
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Trijau S, de Lamotte G, Pradel V, Natali F, Allaria-Lapierre V, Coudert H, Pham T, Sciortino V, Lafforgue P. Osteoporosis prevention among chronic glucocorticoid users: results from a public health insurance database. RMD Open 2016; 2:e000249. [PMID: 27486526 PMCID: PMC4947732 DOI: 10.1136/rmdopen-2016-000249] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/09/2016] [Accepted: 05/12/2016] [Indexed: 01/29/2023] Open
Abstract
Introduction Long-term glucocorticoid therapy is the leading cause of secondary osteoporosis. The management of glucocorticoid-induced osteoporosis (GIOP) seems to be inadequate in many European countries. Objective To evaluate the rate of screening and treatment of GIOP. Design Information was collected from a national public health-insurance database in our geographic area of Provence-Alpes-Côte-d'Azur and in Corsica, from September 2009 through August 2011. Patients We identified participants aged 15 years and over starting glucocorticoid therapy (≥7.5 mg of prednisone equivalent per day during at least 90 days consecutive). This cohort was compared with an age-matched and sex-matched population that did not receive glucocorticoids. Main outcome measures Bone mass, prescription of bone antiresorptive medication and use of calcium and/or vitamin D treatment. Results We identified 32 812 patients who were prescribed glucocorticoid therapy, yielding 1% prevalence. Incidence of glucocorticoid therapy was 2.8/1000 inhabitants/year. Males represented 44%, the mean age was 58 years. The median prednisone-equivalent dose was 11 mg/day (IQR 9–18 mg/day). 8% underwent bone mass measurement. Calcium and/or vitamin D, and bisphosphonates were prescribed in 18% and 12%, respectively. Results were lower for the control population: 3% underwent bone mass measurement and 3% received bisphosphonate therapy. The rates of osteodensitometry and treatments were higher in women over 55 years of age than in men and women 55 years of age and younger, and also when glucocorticoid therapy was initiated by a rheumatologist versus other physician specialty. Conclusions The management of GIOP remains very inadequate, despite the availability of a statutory health insurance system. Targeted interventions are needed to improve the management of GIOP.
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Affiliation(s)
- Sophie Trijau
- Service de Rhumatologie , APHM, Hôpital Sainte-Marguerite , Marseille , France
| | - Gaëlle de Lamotte
- Service de Rhumatologie, APHM, Hôpital Sainte-Marguerite, Marseille, France; Faculté de Médecine, Aix-Marseille Université, Marseille, France
| | - Vincent Pradel
- Service de Santé Publique et d'Information Médicale , APHM, Hôpital Sainte-Marguerite , Marseille , France
| | - François Natali
- Direction Régionale du Service Médical du Régime Général de l'Assurance Maladie Paca Corse , Marseille , France
| | - Véronique Allaria-Lapierre
- Direction Régionale du Service Médical du Régime Général de l'Assurance Maladie Paca Corse , Marseille , France
| | - Hervé Coudert
- Direction Régionale du Service Médical du Régime Général de l'Assurance Maladie Paca Corse , Marseille , France
| | - Thao Pham
- Service de Rhumatologie, APHM, Hôpital Sainte-Marguerite, Marseille, France; Faculté de Médecine, Aix-Marseille Université, Marseille, France
| | - Vincent Sciortino
- Direction Régionale du Service Médical du Régime Général de l'Assurance Maladie Paca Corse , Marseille , France
| | - Pierre Lafforgue
- Service de Rhumatologie, APHM, Hôpital Sainte-Marguerite, Marseille, France; Faculté de Médecine, Aix-Marseille Université, Marseille, France
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