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Osteoporosis International

, Volume 28, Issue 10, pp 3055–3060 | Cite as

The effects of a patient activation intervention on smoking and excessive drinking cessations: results from the PAADRN randomized controlled trial

  • F. D. WolinskyEmail author
  • Y. Lou
  • S. W. Edmonds
  • K. G. Saag
  • D. W. Roblin
  • N. C. Wright
  • M. P. Jones
  • P. Cram
  • on behalf of the PAADRN Investigators
Short Communication

Abstract

Summary

Patients may exhibit risky bone health behaviors. In a large pragmatic clinical trial, we tested whether a tailored patient activation DXA result letter accompanied by a bone health brochure led to smoking and excessive drinking cessations. The intervention did not, however, alter these risky bone health behaviors.

Introduction

Besides dual-energy x-ray absorptiometry (DXA) screening and pharmacotherapy when indicated, beneficial bone health behaviors including proper calcium and vitamin D intake and weight-bearing and muscle-strengthening exercise should be encouraged. Similarly, risky bone health behaviors like smoking and excessive drinking should be discouraged. We examined whether a direct-to-patient activation intervention led to smoking and excessive drinking cessations.

Methods

The Patient Activation after DXA Result Notification (PAADRN) pragmatic clinical trial enrolled 7749 patients between February 2012 and August 2014. Interviews occurred at baseline and 12 and 52 weeks later. Intervention subjects were mailed an individually tailored DXA results letter accompanied by a bone health educational brochure 4 weeks post-DXA. Usual care subjects were not sent these materials. Smoking and excessive drinking were assessed by self-report at each interview. Intention-to-treat linear probability models were used.

Results

Mean age was 66.6 years, 83.8% were women, and 75.3% were Non-Hispanic-Whites. Smoking was reported at baseline by 7.6% of the intervention group vs. 7.7% of the usual care group (p = 0.873). Excessive drinking was reported at baseline by 6.5% of the intervention group vs. 6.5% of the usual care group (p = 0.968). Intention-to-treat analyses indicated no significant differences between the intervention vs. usual care groups at either 12 or 52 weeks post-DXA (all p values ≥ 0.346).

Conclusion

An individually tailored DXA result letter accompanied by an educational brochure did not lead to smoking or excessive drinking cessations in patients who received DXA.

Trial Registration: clinicaltrials.gov identifier NCT01507662.

Keywords

Clinical trials Drinking DXA Osteoporosis Smoking 

Notes

Compliance with ethical standards

Funding/support

This work was supported by R01 AG033035 (Cram/Wolinsky) from the NIA at NIH. Dr. Cram is supported by a K24 AR062133 award from NIAMS at the NIH. Dr. Saag is supported by a K24 AR052361 award from the NIAMS at the NIH.

Conflicts of interest

F. D. Wolinsky, Y. Lou, S. W. Edmonds, D. W. Roblin, M. P. Jones, and P. Cram, have no conflicts of interest. N. C. Wright has received unrestricted grant support from Amgen for work unrelated to this project. K. G. Saag has received grants from Amgen, Eli Lilly and Merck and has served as a paid consultant to Amgen, Eli Lilly, and Merck unrelated to this project.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2017

Authors and Affiliations

  • F. D. Wolinsky
    • 1
    • 2
    • 3
    Email author
  • Y. Lou
    • 4
  • S. W. Edmonds
    • 2
    • 3
    • 5
  • K. G. Saag
    • 6
  • D. W. Roblin
    • 7
    • 8
  • N. C. Wright
    • 6
    • 9
  • M. P. Jones
    • 4
  • P. Cram
    • 2
    • 10
    • 11
  • on behalf of the PAADRN Investigators
  1. 1.Department of Health Management and PolicyUniversity of IowaIowa CityUSA
  2. 2.Department of Internal MedicineUniversity of IowaIowa CityUSA
  3. 3.College of NursingUniversity of IowaIowa CityUSA
  4. 4.Department of BiostatisticsUniversity of IowaIowa CityUSA
  5. 5.CADRE, Iowa City VA Healthcare SystemIowa CityUSA
  6. 6.Department of Internal MedicineUniversity of AlabamaBirminghamUSA
  7. 7.Kaiser PermanenteAtlantaUSA
  8. 8.Department of Health Management and PolicyGeorgia State UniversityAtlantaUSA
  9. 9.Department of EpidemiologyUniversity of AlabamaBirminghamUSA
  10. 10.Department of MedicineUniversity of TorontoTorontoCanada
  11. 11.Division of General Internal Medicine and GeriatricsMt. Sinai/UHN HospitalsTorontoCanada

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