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

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 knowledge and improve patient care?

  • 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 knowledge and improve patient care?

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

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


Study preparation
Study Preparation knowledge and improve patient care?

  • 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 knowledge and improve patient care?

  • 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 knowledge and improve patient care?

  • 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 knowledge and improve patient care?

  • 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 knowledge and improve patient care?


Physician knowledge significantly improves
Physician Knowledge Significantly Improves knowledge and improve patient care?

p=0.03, Wilcoxon rank sum test


Patient care scores remain the same
Patient Care Scores Remain the Same knowledge and improve patient care?


Study strengths weaknesses
Study Strengths & Weaknesses knowledge and improve patient care?

  • 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 knowledge and improve patient care?

  • 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 “ knowledge and improve patient care? 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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