Can a web based osteoporosis lecture increase physician knowledge and improve patient care
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Can a web-based osteoporosis lecture increase physician knowledge and improve patient care?. Karen E. Hansen, MD Assistant Professor of Medicine University of Wisconsin. Background. Osteoporosis is highly prevalent

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Can a web-based osteoporosis lecture increase physician knowledge and improve patient care?

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Can a web based osteoporosis lecture increase physician knowledge and improve patient care

Can a web-based osteoporosis lecture increase physician knowledge and improve patient care?

Karen E. Hansen, MD

Assistant Professor of Medicine

University of Wisconsin


Background

Background

  • Osteoporosis is highly prevalent

  • Even following hospitalization for fragility fracture, many patients remain untreated

  • Effective osteoporosis therapies are available, decreasing fracture rates by ~50%


Study hypotheses

Study Hypotheses

  • An on-line lecture will increase physician knowledge about osteoporosis

  • An on-line lecture about osteoporosis can improve patient care


Study preparation

Study Preparation

  • Slide lecture developed

  • Voice portion recorded and loaded onto web

  • Pre-test and post-test developed with assistance from Craig Gjerde, Ph.D.

  • Pre-test and post-test embedded in web based program

  • Chart review form developed for assessment of change in patient care

  • UW IRB Protocol and consent form developed, approved by HSC


Study design phase 1

Study Design- Phase 1

  • Email invitation sent to 30 IM Faculty

  • Consent obtained by Elaine Rosenblatt

  • Elaine provides internet link to web-based lecture

  • Physicians can access lecture at any time and from any location

  • Must complete pre-test and post-test

  • Receive $50 for participation


Study design phase 2

Study Design- Phase 2

  • From the clinics of consenting doctors, Elaine identifies five new postmenopausal women at least 60 years of age

  • Initial clinic note printed, identifiers removed

  • Chart review form used to identify physician recorded history, exam, and treatment plan pertaining to osteoporosis


Study design phase 3

Study Design- Phase 3

  • Each patient note reviewed twice to determine patient care scores

  • Discrepancies resolved by 3rd review

  • Data entered in duplicate into Excel

  • Data charted to determine whether parametric or non-parametric

  • Wilcoxon rank sum test used in statistical analyses


Chart review form

Chart Review Form


Physician knowledge significantly improves

Physician Knowledge Significantly Improves

p=0.03, Wilcoxon rank sum test


Patient care scores remain the same

Patient Care Scores Remain the Same


Study strengths weaknesses

Study Strengths & Weaknesses

  • Small sample size

    • Patient and Physician

  • Performance setting

    • New patient visit

    • Physician unaware that visit would be “judged” in a study

    • Patient unaware that visit would be assessed by external reviewer wrt osteoporosis

  • Selection bias

    • Physician participants may have different knowledge or interest in OP than those who did not participate


Conclusions

Conclusions

  • In this small study, an on-line osteoporosis lecture did increase physician knowledge

  • However, no change in patient care was noted

  • Further research studies are needed to determine optimal teaching methods that favorably influence patient care


A sincere thank you to

A Sincere “Thank You” to:

  • Elaine Rosenblatt

  • Physician participants

  • Internal Medicine Section, R&D Committee

  • George Mejicano

  • Craig Gjerde

  • CME Office

  • UW Human Subjects Committee

  • Matt Crowe


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