An Internet-based Controlled Trial Aimed to Improve Osteoporosis Prevention among Chronic Glucocorticoid Users
Department of Quantitative Health Sciences
Medical Subject Headings
Adult; Aged; Aged, 80 and over; Bone Density; Female; Glucocorticoids; Humans; Middle Aged; Osteoporosis
Health Information Technology | Musculoskeletal Diseases | Public Health Education and Promotion | Rheumatology
OBJECTIVE: To address the low prevention and treatment rates for those at risk of glucocorticoid-induced osteoporosis (GIOP), we evaluated the influence of a direct-to-patient, Internet-based educational video intervention using "storytelling" on rates of antiosteoporosis medication use among chronic glucocorticoid users who were members of an online pharmacy refill service.
METHODS: We identified members who refilled > /= 5 mg/day of prednisone (or equivalent) for 90 contiguous days and had no GIOP therapy for > /= 12 months. Using patient stories, we developed an online video addressing risk factors and treatment options, and delivered it to members refilling a glucocorticoid prescription. The intervention consisted of two 45-day "Video ON" periods, during which the video automatically appeared at the time of refill, and two 45-day "Video OFF" periods, during which there was no video. Members could also "self-initiate" watching the video by going to the video link. We used an interrupted time series design to evaluate the effectiveness of this intervention on GIOP prescription therapies over 6 months.
RESULTS: Among 3017 members (64.8%) exposed to the intervention, 59% had measurable video viewing time, of which 3% "self-initiated" the video. The GIOP prescription rate in the "Video ON" group was 2.9% versus 2.7% for the "Video OFF" group. There was a nonsignificant trend toward greater GIOP prescription in members who self-initiated the video versus automated viewing (5.7% vs 2.9%, p = 0.1).
CONCLUSION: Among adults at high risk of GIOP, prescription rates were not significantly affected by an online educational video presented at the time of glucocorticoid refill.
ClinicalTrials.gov Identifier: NCT01378689.
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Citation: J Rheumatol. 2015 Aug;42(8):1478-83. doi: 10.3899/jrheum.141238. Epub 2015 Jul 1. Link to article on publisher's site
Warriner, Amy H.; Outman, Ryan C.; Allison, Jeroan J.; Curtis, Jeffrey R.; Markward, Nathan J.; Redden, David T.; Safford, Monika M.; Stanek, Eric J.; Steinkellner, Amy R.; and Saag, Kenneth G., "An Internet-based Controlled Trial Aimed to Improve Osteoporosis Prevention among Chronic Glucocorticoid Users" (2015). University of Massachusetts Medical School Faculty Publications. 955.