Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/36039
Title: Improvement of osteoporosis Care Organized by Nurses: ICON study - Protocol of a quasi-experimental study to assess the (cost)-effectiveness of combining a decision aid with motivational interviewing for improving medication persistence in patients with a recent fracture being treated at the fracture liaison service
Authors: Cornelissen, Dennis
Boonen, Annelies
Evers, Silvia
VAN DEN BERGH, Joop 
Bours, Sandrine
Wyers, Caroline E.
van Kuijk, Sander
van Oostwaard, Marsha
van der Weijden, Trudy
Hiligsmann, Mickael
Issue Date: 2021
Publisher: BMC
Source: BMC MUSCULOSKELETAL DISORDERS, 22 (1) (Art N° 913)
Abstract: Background Given the health and economic burden of fractures related to osteoporosis, suboptimal adherence to medication and the increasing importance of shared-decision making, the Improvement of osteoporosis Care Organized by Nurses (ICON) study was designed to evaluate the effectiveness, cost-effectiveness and feasibility of a multi-component adherence intervention (MCAI) for patients with an indication for treatment with anti-osteoporosis medication, following assessment at the Fracture Liaison Service after a recent fracture. The MCAI involves two consultations at the FLS. During the first consultation, a decision aid is will be used to involve patients in the decision of whether to start anti-osteoporosis medication. During the follow-up visit, the nurse inquires about, and stimulates, medication adherence using motivational interviewing techniques. Methods A quasi-experimental trial to evaluate the (cost-) effectiveness and feasibility of an MCAI, consisting of a decision aid (DA) at the first visit, combined with nurse-led adherence support using motivational interviewing during the follow-up visit, in comparison with care as usual, in improving adherence to oral anti-osteoporosis medication for patients with a recent fracture two Dutch FLS. Medication persistence, defined as the proportion of patients who are persistent at one year assuming a refill gap < 30 days, is the primary outcome. Medication adherence, decision quality, subsequent fractures and mortality are the secondary outcomes. A lifetime cost-effectiveness analysis using a model-based economic evaluation and a process evaluation will also be conducted. A sample size of 248 patients is required to show an improvement in the primary outcome with 20%. Study follow-up is at 12 months, with measurements at baseline, after four months, and at 12 months. Discussion We expect that the ICON-study will show that the MCAI is a (cost-)effective intervention for improving persistence with anti-osteoporosis medication and that it is feasible for implementation at the FLS.
Notes: Cornelissen, D (corresponding author), Maastricht Univ, Care & Publ Hlth Res Inst CAPHRI, Dept Hlth Serv Res, POB 616, NL-6200 MD Maastricht, Netherlands.
d.cornelissen@maastrichtuniversity.nl
Keywords: Cost-effectiveness; Process evaluation; Decision aid; Osteoporosis;;Patient participation; Protocol; Medication adherence; Medication;persistence; Fracture liaison service; Nurse
Document URI: http://hdl.handle.net/1942/36039
e-ISSN: 1471-2474
DOI: 10.1186/s12891-021-04743-2
ISI #: WOS:000712823300002
Category: A1
Type: Journal Contribution
Validations: ecoom 2022
Appears in Collections:Research publications

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