Evidence map›Paper›PMID 28620779›Full record

Trial reportOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2017

The cost of a patient activation intervention for achieving successful outcomes: results from the PAADRN randomized controlled trial.

F D Wolinsky, S F Hall, Y Lou, S W Edmonds, K G Saag, D W Roblin, N C Wright, M P Jones, P Cram, PAADRN Investigators and 5 more

Registry-linked trialOpen access · greenAbstract readMulticenter StudyRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01507662 (Patient Activation After DXA Result Notification), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 91% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01507662 nacompletednot on this map

Patient Activation After DXA Result Notification

TypeinterventionalSponsorFredric D WolinskyRan2012 to 2015Enrolled7,749ConditionsOsteoporosis, Bone Diseases, MetabolicArmsBone Mineral Density Result Letter and Bone Health Brochure
3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 2 countries.

F D WolinskyDepartment of Health Management and Policy, University of Iowa, 145 North Riverside Drive, CPHB N211, Iowa City, IA, 52242, USA. fredric-wolinsky@uiowa.edu.
S F HallDepartment of Internal Medicine, University of Iowa, Iowa City, IA, USA.
Y LouDepartment of Biostatistics, University of Iowa, Iowa City, IA, USA.
S W EdmondsDepartment of Internal Medicine, University of Iowa, Iowa City, IA, USA.
K G SaagDepartment of Internal Medicine, University of Alabama, Birmingham, AL, USA.
D W RoblinKaiser Permanente, Atlanta, GA, USA.
N C WrightDepartment of Internal Medicine, University of Alabama, Birmingham, AL, USA.
M P JonesDepartment of Biostatistics, University of Iowa, Iowa City, IA, USA.
P CramDepartment of Internal Medicine, University of Iowa, Iowa City, IA, USA.
PAADRN Investigators
J R Curtis
S L Morgan
J A Schlechte
J H Williams
D J Zelman
University of Iowa · USKaiser Permanente · US

Funding

A Patient Activation Intervention to Enhance Bone HealthR01AG033035 · NIA · UNIVERSITY OF IOWA · PI WOLINSKY, FREDRIC D · 2010 to 2014
$7.0M
Mid-Career Investigator Award (for Kenneth G. Saag, MD, MSc)K24AR052361 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2005 to 2014
$1.7M
Building Musculoskeletal Outcomes Research at the University of IowaK24AR062133 · NIAMS · UNIVERSITY OF IOWA · PI CRAM, PETER M · 2012 to 2016
$594k
NIAMS NIH HHS K24 AR052361NIAMS NIH HHS K24 AR062133NIA NIH HHS R01 AG033035
6 · The paper itself

Abstract

In a large, pragmatic clinical trial, we calculated the costs of achieving four successful patient-centered outcomes using a tailored patient activation DXA result letter accompanied by a bone health brochure. The cost to achieve one successful outcome (e.g., a 0.5 standard deviation improvement in care satisfaction) ranged from $127.41 to $222.75.

introductionPragmatic randomized controlled trials (RCTs) should focus on patient-centered outcomes and report the costs for achieving those outcomes. We calculated per person incremental intervention costs, the number-needed-to-treat (NNT), and incremental per patient costs (cost per NNT) for four patient-centered outcomes in a direct-to-patient bone healthcare intervention.

methodsThe Patient Activation after DXA Result Notification (PAADRN) pragmatic RCT enrolled 7749 patients presenting for DXA at three health centers between February 2012 and August 2014. Interviews occurred at baseline and 52 weeks post-DXA. Intervention subjects received an individually tailored DXA result letter accompanied by an educational bone health brochure 4 weeks post-DXA, while the usual care subjects did not. Outcomes focused on patients (a) correctly identifying their results, (b) contacting their providers, (c) discussing their results with their providers, and (d) satisfaction with their bone healthcare. NNTs were determined using intention-to-treat linear probability models, per person incremental intervention costs were calculated, and costs per NNT were computed.

resultsMean age was 66.6 years old, 83.8% were women, and 75.3% were non-Hispanic whites. The incremental per patient cost (costs per NNT) to increase the ability of a patient to (a) correctly identify their DXA result was $171.07; (b) contact their provider about their DXA result was $222.75; (c) discuss their DXA result with their provider was $193.55; and (d) achieve a 0.5 SD improvement in satisfaction with their bone healthcare was $127.41.

conclusionAn individually tailored DXA result letter accompanied by an educational brochure can improve four patient-centered outcomes at a modest cost.

trial registrationclinicaltrials.gov identifier NCT01507662.

Indexed as

Health Knowledge, Attitudes, PracticeAbsorptiometry, PhotonAgedAlabamaCommunicationCorrespondence as TopicFemaleGeorgiaHealth Care CostsHumansMaleMiddle AgedOsteoporosisPamphletsPatient Education as TopicPatient Outcome AssessmentClinical trialsCostsDXAOsteoporosisPatient activation

Identifiers

PMID28620779
PMCPMC5670012
OpenAlexW2626739370

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.