Evidence map›Paper›PMID 29307094›Full record

Trial reportArchives of osteoporosis2018

Diet and exercise changes following bone densitometry in the Patient Activation After DXA Result Notification (PAADRN) study.

Douglas W Roblin, Peter Cram, Yiyue Lou, Stephanie W Edmonds, Sylvie F Hall, Michael P Jones, Kenneth G Saag, Nicole C Wright, Fredric D Wolinsky, PAADRN Investigators

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Archives of osteoporosis, 2018. 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. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 31% 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

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Trial
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

10 authors at 3 institutions in 2 countries.

Douglas W RoblinMid-Atlantic Permanente Research Institute, 2101 East Jefferson St., 3 West, Rockville, MD, 20852, USA. Douglas.W.Roblin@KP.Org.
Peter CramDivision of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Yiyue LouDepartment of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA.
Stephanie W EdmondsDivision of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Sylvie F HallCollege of Nursing, University of Iowa, Iowa City, IA, USA.
Michael P JonesDepartment of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA.
Kenneth G SaagDivision of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Nicole C WrightDivision of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Fredric D WolinskyDivision of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
PAADRN Investigators
University of Iowa · USKaiser Permanente · USUniversity of Alabama at Birmingham · US

Funding

A Patient Activation Intervention to Enhance Bone HealthR01AG033035 · NIA · UNIVERSITY OF IOWA · PI WOLINSKY, FREDRIC D · 2010 to 2014
$7.0M
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 AR062133NIA NIH HHS R01 AG033035
6 · The paper itself

Abstract

Calcium and vitamin D intake and exercise are suboptimal among older adults. Following bone densitometry, a letter communicating individualized fracture risk accompanied by an educational brochure improved participants' lifestyle-but no more than existing communication strategies-over 52 weeks. Simple communication strategies are insufficient for achieving optimal levels of bone health behaviors. PURPOSE: The Patient Activation After DXA Result Notification (PAADRN) study was designed to evaluate whether a letter with individualized fracture risk and an educational brochure mailed to patients soon after their DXA might improve bone health behaviors (daily calcium intake, vitamin D supplementation, and weekly exercise sessions) compared to slower, less individualized communication characterizing usual care.

methodsParticipants ≥ 50 years were recruited, at three sites, following their DXA and randomized with 1:1 allocation to intervention and control (usual care only) groups. Data were collected at enrollment interview and by phone survey at 12 and 52 weeks thereafter. Intention-to-treat analyses were conducted on 7749 of the 20,397 eligible participants who enrolled. Changes in bone health behaviors were compared within and between study groups. Average treatment effects and heterogeneity of treatment effects were estimated with multivariable linear and logistic regression models.

resultsIn unadjusted analyses, calcium intake, vitamin D supplementation, and weekly exercise sessions increased significantly over 52 weeks within both the intervention and control groups (all p < 0.001). In unadjusted analyses and multivariable models, increases in each behavior did not significantly differ between the intervention and control groups. Intervention group participants with a > 20% 10-year fracture risk at enrollment did, however, have a significantly greater increase in calcium intake compared to other study participants (p = 0.031).

conclusionsBone health behaviors improved, on average, over 52 weeks among all participants following a DXA. Receipt of the PAADRN letter and educational brochure did not directly improve bone health behaviors compared to usual care.

trial registrationThe Patient Activation after DXA Result Notification (PAADRN) Study is registered at ClinicalTrials.Gov: NCT01507662, https://clinicaltrials.gov/ct2/show/NCT01507662.

Indexed as

Health BehaviorAbsorptiometry, PhotonAgedCalcium, DietaryDietDietary SupplementsExerciseFemaleFractures, BoneHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedOsteoporosisPamphletsPatient Education as TopicCalcium, DietaryVitamin DDietExerciseFracture riskOsteoporosisPatient-provider communication

Identifiers

PMID29307094
PMCPMC7409367
OpenAlexW2781789668

What OpenQuestion holds

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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.