We assessed the impact of an intensive outreach program in postmenopausal women (age 67–85y) with osteoporosis over 3, 6, and 12 months (mos). Medicare Advantage members with evidence of a fragility fracture (fx) from 15Apr2016–27Jan2017 and 23Oct2017–27Nov2017 were eligible. Randomisation was to a current health plan program (standard-of-care [SOC]); or an intensive outreach intervention, which, in addition to SOC, included educational mailing to patients, post–heel scan follow-up phone calls to patients and providers, and an informational fax and phone call to providers. Study endpoints were: 1) composite of DXA monitoring and/or osteoporosis medication fill, 2) DXA monitoring, 3) osteoporosis medication fill, and 4) subsequent fxs.
Over 12 mos, 3,720 patients (1,847 intervention; 1,873 SOC) were followed up; only 98 (5.3%) patients and 678 (36.7%) providers were eligible for phone outreach and successfully contacted. The results were consistent across mos 3, 6, and 12. At 12 mos, the intervention group had a statistically significant greater proportion of DXA monitoring and/or osteoporosis medication fill vs. SOC (32.7% vs. 29.5%; p=0.036) and a greater proportion of DXA monitoring alone vs. SOC (29.9% vs. 26.1%; p=0.009). No significant differences between intervention and SOC were found for medication fill alone (10.5% vs. 10.1%, respectively; p=0.759) or subsequent fxs (21.0% vs. 21.7%; p=0.591). The overall osteoporosis medication fill for all patients was 6.8% within 6 mos and 10.3% within 12 mos. Further, 21.4% of all patients experienced an additional fx, and 4.4% experienced multiple fxs.
In conclusion, the intensive outreach program increased post-fx DXA monitoring vs. SOC, with no differences between groups in medication fill or subsequent fxs. Addressing the barriers encountered in this study to increase contact with patients and providers may be needed to increase osteoporosis monitoring and use of osteoporosis medication and reduce subsequent fxs during post-fx care.