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dc.contributor.authorAndreasen, Camilla
dc.contributor.authorSolberg, Lene Bergendal
dc.contributor.authorBasso, Trude
dc.contributor.authorBorgen, Tove Tveitan
dc.contributor.authorDahl, Cecilie
dc.contributor.authorWisløff, Torbjørn
dc.contributor.authorHagen, Gunhild
dc.contributor.authorApalset, Ellen M
dc.contributor.authorGjertsen, Jan-Erik
dc.contributor.authorFigved, Wender
dc.contributor.authorHübschle, Lars Michael
dc.contributor.authorStutzer, Jens-Meinhard
dc.contributor.authorElvenes, Jan
dc.contributor.authorJoakimsen, Ragnar Martin
dc.contributor.authorSyversen, Unni
dc.contributor.authorEriksen, Erik Fink
dc.contributor.authorNordsletten, Lars
dc.contributor.authorFrihagen, Frede Jon
dc.contributor.authorOmsland, Tone Kristin
dc.contributor.authorBjørnerem, Åshild
dc.identifier.citationAndreasen C, Solberg LB, Basso T, Borgen TT, Dahl C, Wisløff T, Hagen G, Apalset EM, Gjertsen JE, Figved W, Hübschle LM, Stutzer J, Elvenes J, Joakimsen RM, Syversen U, Eriksen EF, Nordsletten L, Frihagen FJ, Omsland TK, Bjørnerem Å. The Norwegian Capture the Fracture Initiative a stepped wedge cluster randomized 1 controlled trial of a Fracture Liaison Service model of care: The NoFRACT Trial Protocol. Jama Network Open. 2018;1(8):e185701eng
dc.description.abstract<p>Importance: Fragility fracture is a major health issue because of the accompanying morbidity, mortality, and financial cost. Despite the high cost to society and personal cost to affected individuals, secondary fracture prevention is suboptimal in Norway, mainly because most patients with osteoporotic fractures do not receive treatment with antiosteoporotic drugs after fracture repair.</p> <p>Objectives: To improve secondary fracture prevention by introducing a standardized intervention program and to investigate the effect of the program on the rate of subsequent fractures.</p> <p>Design, Setting, and Participants: Trial protocol of the Norwegian Capture the Fracture Initiative (NoFRACT), an ongoing, stepped wedge cluster randomized clinical trial in 7 hospitals in Norway. The participating hospitals were cluster randomized to an intervention starting date: May 1, 2015; September 1, 2015; and January 1, 2016. Follow-up is through December 31, 2019. The outcome data were merged from national registries of women and men 50 years and older with a recent fragility fracture treated at 1 of the 7 hospitals.</p> <p>Discussion: The NoFRACT trial is intended to enroll 82 000 patients (intervention period, 26 000 patients; control period, 56 000 patients), of whom 23 578 are currently enrolled by January 2018. Interventions include a standardized program for identification, assessment, and treatment of osteoporosis in patients with a fragility fracture that is led by a trained coordinating nurse. The primary outcome is rate of subsequent fracture (per 10 000 person-years) based on national registry data. Outcomes before (2008-2015; control period) and after (2015-2019; intervention period) the intervention will be compared, and each hospital will act as its own control. Use of outcomes from national registry data means that all patients are included in the analysis regardless of whether they are exposed to the intervention (intention to treat). A sensitivity analysis with a transition window will be performed to mitigate possible within-cluster contamination.</p> <p>Results: Results are planned to be disseminated through publications in peer-reviewed journals and presented at local, national, and international conferences.</p> <p>Conclusions: By introducing a standardized intervention program for assessment and treatment of osteoporosis in patients with fragility fractures, we expect to document reduced rates of subsequent fractures and fracture-related mortality.</p>eng
dc.publisherAmerican Medical Associationeng
dc.rightsAttribution CC BYeng
dc.titleThe Norwegian Capture the Fracture Initiative a stepped wedge cluster randomized 1 controlled trial of a Fracture Liaison Service model of care: The NoFRACT Trial Protocoleng
dc.typeJournal articleeng
dc.rights.holderCopyright 2018 The Author(s)eng
bora.peerreviewedPeer reviewedeng
dc.type.documentJournal article
dc.relation.journalJama Network Open

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