Correlation between patient recall of bone densitometry results and subsequent treatment adherence.
ABSTRACT Treatment of osteoporosis is often inadequate. One reason can be insufficient patient education following diagnostic bone densitometry (DXA). Therefore, we studied how patients are informed and treated following their first DXA. Individuals who had DXA at a rural hospital in Wisconsin were surveyed with a questionnaire regarding their post-test education and prescribed treatment. Their DXA results and the specialty of their clinician were also recorded. Eighty percent of the 1,014 participants were informed of their results. Of the 341 participants who had normal bone mineral density (BMD), 63% reported correct results, while only 31% of the 309 who had osteopenia and 50% of the 364 who had osteoporosis reported correct results. Accuracy in reporting was not affected by the patients' age or the specialty of their clinicians. Following DXA, 339 patients (33%) were started on medications; 86% of those remained on some prescribed therapy for osteoporosis, but 140 (41%) did not continue the initial medication. Reasons for discontinuation included side effects (48%) and cost (26%). Patients with low BMD who correctly reported their results were more likely to have received a medication and to continue to take it ( p <0.0001). Calcium supplements were recommended to 65% of those not taking calcium prior to DXA. Internists were more likely than family practitioners to recommend calcium, and their patients reported better medication adherence, as did those with osteoporosis compared with osteopenia. We conclude that, while most participants are informed of the results of their DXAs, the retained information may not be accurate. Correct understanding of DXA results may lead to higher treatment rates and better adherence to treatment among patients with low BMD.
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ABSTRACT: The objective of this study was to assess factors that affect breast cancer patients' recall of patient assistance services. We surveyed newly-diagnosed breast cancer patients and compared recall of receiving patient assistance services at 2 weeks and 6 months in a patient-assistance randomized controlled trial aimed to connect women to such programs. The intervention group received information about assistance programs targeted to their practical, psychosocial, and/or informational needs; the control group received a Department of Health pamphlet about breast cancer and its treatment, including a list of patient assistance services. Of 333 women, 210 (63%) reported informational, 183 (55%) psychosocial and 177 (53%) practical needs. At 2 weeks, 96% (202/210) of women with informational needs reported receiving informational material but at 6 months, recall dropped to 69% (140/210). All women whose informational needs were met recalled receiving information, compared to 31% whose needs were unmet (p < 0.0001). Of 109 intervention patients with psychosocial or practical needs, 77% (79) contacted a program specified in their action plan at 2 weeks. However, at 6 months, only 39% (31/79) recalled contacting a program. Women without recall were less likely to report having their needs met (6% vs. 58%; p < 0.001). Recall of patient assistance services is strongly related to having needs met. Use of patient surveys to evaluate utilization or impact of such programs should be used with caution due to poor patient recall. CLINICAL TRIALS # NCT00233077: http://www.clinicaltrials.gov/ct2/show/NCT00233077?term=Nina+Bickell&rank=2.SpringerPlus 10/2012; 1:24. DOI:10.1186/2193-1801-1-24
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ABSTRACT: The oxidation of DNA and RNA provides a facile approach for investigating the interaction of nucleic acids with proteins and oligonucleotides. In this article, we have outlined our understanding of the mechanism of DNA scission by 1,10-phenanthroline-copper(I) in the presence of hydrogen peroxide. We also discuss results obtained by using 1,10-phenanthroline-oligonucleotide conjugates in probing the size of the transcriptionally active open complex. Finally, we outline an effective method for converting DNA-binding proteins into site-specific modification agents by using 1,10-phenanthroline-copper(I).ChemBioChem 11/2001; 2(10):735-40. DOI:10.1002/1439-7633(20011001)2:103.0.CO;2-# · 3.06 Impact Factor