Abstract
The Ontario Osteoporosis Strategy for long-term care (LTC) aims to support fracture
risk-reduction. LTC specific recommendations for fracture prevention were developed
in 2015. This article describes the use of the Knowledge-to Action framework to guide
the development and application of research evidence on fracture prevention in older
adults. Knowledge translation activities highlighted fractures as a significant source
of morbidity in LTC, significant gaps in fracture risk assessment and treatment, and
barriers and facilitators to guideline implementation. Multifaceted knowledge translation
strategies, targeting staff in LTC homes in Ontario, Canada to support fracture guideline
implementation have included education, audit and feedback, team-based action planning,
and engagement of LTC residents, their families, and health professionals. Provincial
administrative databases were accessed to monitor fracture rates between 2005 and
2015. Our research has identified enablers and barriers to knowledge use such as limited
knowledge of osteoporosis, fracture risk, and prevention. Province-wide over a 10-year
period, hip fracture rates in LTC decreased from 2.3% to 1.9%, and any fracture rates
decreased from 4% to 3.6%. This body of work suggests that multifaceted knowledge
translation initiatives are feasible to implement in LTC and can improve the uptake
of clinical recommendations for fracture prevention. A key aspect of our fracture
prevention knowledge translation activities has been the full engagement of key stakeholders
to assist in the co-development and design of knowledge translation products.
Keywords
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Article info
Publication history
Published online: August 14, 2020
Footnotes
Alexandra Papaionnou has been on the Amgen Advisory Board and has received research support and honoraria from Amgen. Jonathan Adachi has received research support and honoraria from Amgen and Radius. Ravi Jain is the Director of the Ontario Osteoporosis Strategy, Osteoporosis Canada. Loretta Hillier is the Program Manager for the Osteoporosis Strategy in Long-Term Care. All of the remaining authors report no conflicts of interest.
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
