Improving osteoporosis care through multimodal interventions: insights from the University of Alabama at Birmingham Center for Education and Research on Therapeutics

Abstract

Despite the many advances in scientific research over the last several decades, cutting edge technologies and therapeutics often take many years to find their way into widespread use. The dissemination and uptake of best practices into clinical care is sometimes a neglected component of research that is essential to improve the population's health. Type 2 translational research, sometimes called "Proof in Practice Research," seeks to maximize the yield of what has been learned from the bench and from carefully controlled clinical trials and to extend those benefits to a larger population. One aspect of type 2 translational research, sometimes called evidence implementation or implementation science, applies what has been learned about clinical medicine to achieve best practices across providers and health systems. This article describes evidence implementation as applied to osteoporosis care, drawing from several published or ongoing studies to illustrate challenges and potential solutions in improving the quality of osteoporosis care.

Figure 1

Relationship Between Type 1 (Proof of Concept) and Type II (Proof in Practice) Translational Research across the Spectrum of Clinical Research. Diagram is based on the report written by members of the Clinical Research Roundtable of the Institute of Medicine[1]

Figure 2

Overview of Study Design of Group Randomized Trial of a Multi-modal Intervention to Improve Glucocorticoid Induced Osteoporosis Management among in a Large U.S. Managed Health Plan. [17]

Figure 3

Operational Aspects to an Intervention to Identify and Offer Women the Opportunity to Undergo DXA Testing [9]

Figure 4

Overview of Aspects of Narrative Communication that May Result in Changes in Patients’ Attitudes and Behaviors[18]