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

  2. 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%

  3. Study Hypotheses • An on-line lecture will increase physician knowledge about osteoporosis • An on-line lecture about osteoporosis can improve patient care

  4. 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

  5. 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

  6. 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

  7. 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

  8. Chart Review Form

  9. Physician Knowledge Significantly Improves p=0.03, Wilcoxon rank sum test

  10. Patient Care Scores Remain the Same

  11. 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

  12. 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

  13. 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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