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Published in: Osteoporosis International 10/2017

01-10-2017 | Short Communication

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

Authors: F. D. Wolinsky, 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

Published in: Osteoporosis International | Issue 10/2017

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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.
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Metadata
Title
The effects of a patient activation intervention on smoking and excessive drinking cessations: results from the PAADRN randomized controlled trial
Authors
F. D. Wolinsky
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
Publication date
01-10-2017
Publisher
Springer London
Published in
Osteoporosis International / Issue 10/2017
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-017-4101-5

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