{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:33:51Z","timestamp":1762324431314},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T00:00:00Z","timestamp":1550534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2003<\/jats:title>\n                  <jats:p>We assessed the cost-effectiveness of two models of osteoporosis care after upper extremity fragility fracture using a high-intensity Fracture Liaison Service (FLS) Case-Manager intervention versus a low-intensity FLS (ie, Active Control), and both relative to usual care. This analysis used data from a pragmatic patient-level parallel-arm comparative effectiveness trial of 361 community-dwelling participants 50 years or older with upper extremity fractures undertaken at a Canadian academic hospital. We used a decision-analytic Markov model to evaluate the cost-effectiveness of the three treatment alternatives. The perspective was health service payer; the analytical horizon was lifetime; costs and health outcomes were discounted by 3%. Costs were expressed in 2016 Canadian dollars (CAD) and the health effect was measured by quality adjusted life years (QALYs). The average age of enrolled patients was 63 years and 89% were female. Per patient cost of the Case Manager and Active Control interventions were $66CAD and $18CAD, respectively. Compared to the Active Control, the Case Manager saved $333,000, gained seven QALYs, and averted nine additional fractures per 1000 patients. Compared to usual care, the Case Manager saved $564,000, gained 14 QALYs, and incurred 18 fewer fractures per 1000 patients, whereas the Active Control saved $231,000, gained seven QALYs, and incurred nine fewer fractures per 1000 patients. Although both interventions dominated usual care, the Case Manager intervention also dominated the Active Control. In 5000 probabilistic simulations, the probability that the Case Manager intervention was cost-effective was greater than 75% whereas the Active Control intervention was cost-effective in less than 20% of simulations. In summary, although the adoption of either of these approaches into clinical settings should lead to cost savings, reduced fractures, and increased quality-adjusted life for older adults following upper extremity fracture, the Case Manager intervention would be the most likely to be cost-effective. \u00a9 2019 American Society for Bone and Mineral Research.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/jbmr.3699","type":"journal-article","created":{"date-parts":[[2019,2,19]],"date-time":"2019-02-19T18:59:17Z","timestamp":1550602757000},"page":"1220-1228","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Cost-Effectiveness of Osteoporosis Interventions to Improve Quality of Care After Upper Extremity Fracture: Results From a Randomized Trial (C-STOP Trial)"],"prefix":"10.1093","volume":"34","author":[{"given":"Sumit R","family":"Majumdar","sequence":"first","affiliation":[{"name":"Department of MedicineUniversity of AlbertaEdmontonABCanada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas A","family":"Lier","sequence":"additional","affiliation":[{"name":"Department of MedicineUniversity of AlbertaEdmontonABCanada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Finlay A","family":"McAlister","sequence":"additional","affiliation":[{"name":"Department of MedicineUniversity of AlbertaEdmontonABCanada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A","family":"Johnson","sequence":"additional","affiliation":[{"name":"School of Public HealthUniversity of AlbertaEdmontonABCanada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian H","family":"Rowe","sequence":"additional","affiliation":[{"name":"Department of Emergency MedicineUniversity of AlbertaEdmontonABCanada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren A","family":"Beaupre","sequence":"additional","affiliation":[{"name":"Department of Physical TherapyUniversity of AlbertaEdmontonABCanada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,2,19]]},"reference":[{"key":"2024021014483649100_jbmr3699-bib-0001","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1359\/jbmr.061113","article-title":"Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025","volume":"22","author":"Burge","year":"2007","journal-title":"J Bone Miner Res"},{"key":"2024021014483649100_jbmr3699-bib-0002","doi-asserted-by":"crossref","first-page":"2713","DOI":"10.1007\/s00198-013-2390-x","article-title":"Changes in frailty-related characteristics of the hip fracture population and their implications for healthcare services: evidence from Quebec","volume":"24","author":"Auais","year":"2013","journal-title":"Canada. Osteoporos Int"},{"key":"2024021014483649100_jbmr3699-bib-0003","doi-asserted-by":"crossref","first-page":"e115","DOI":"10.1097\/BOT.0000000000000222","article-title":"Postoperative length of stay and 30-day readmission after geriatric hip fracture: an analysis of 8434 patients","volume":"29","author":"Basques","year":"2015","journal-title":"J Orthop Trauma"},{"key":"2024021014483649100_jbmr3699-bib-0004","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s12877-016-0332-0","article-title":"A critical review of the long-term disability outcomes following hip fracture","volume":"16","author":"Dyer","year":"2016","journal-title":"BMC Geriatr"},{"key":"2024021014483649100_jbmr3699-bib-0005","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s00198-003-1490-4","article-title":"Mortality after osteoporotic fractures","volume":"15","author":"Johnell","year":"2004","journal-title":"Osteoporos Int"},{"key":"2024021014483649100_jbmr3699-bib-0006","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.bone.2004.03.024","article-title":"A meta-analysis of previous fracture and subsequent fracture risk","volume":"35","author":"Kanis","year":"2004","journal-title":"Bone"},{"key":"2024021014483649100_jbmr3699-bib-0007","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1002\/jbmr.2888","article-title":"A Crisis in the treatment of osteoporosis","volume":"31","author":"Khosla","year":"2016","journal-title":"J Bone Miner Res"},{"key":"2024021014483649100_jbmr3699-bib-0008","year":"2010"},{"key":"2024021014483649100_jbmr3699-bib-0009","year":"2010"},{"key":"2024021014483649100_jbmr3699-bib-0010","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s00198-012-2090-y","article-title":"Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis","volume":"24","author":"Ganda","year":"2013","journal-title":"Osteoporos Int"},{"key":"2024021014483649100_jbmr3699-bib-0011","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.1002\/jbmr.1698","article-title":"Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention","volume":"27","author":"Eisman","year":"2012","journal-title":"J Bone Miner Res"},{"key":"2024021014483649100_jbmr3699-bib-0012","year":"2019"},{"key":"2024021014483649100_jbmr3699-bib-0013","year":"2013"},{"key":"2024021014483649100_jbmr3699-bib-0014","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1007\/s00198-018-4411-2","article-title":"Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature","volume":"29","author":"Wu","year":"2018","journal-title":"Osteoporosis Int"},{"key":"2024021014483649100_jbmr3699-bib-0015","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.bone.2018.03.018","article-title":"Fracture liaison services improve outcomes of patients with osteoporosis-related fractures: a systematic literature review and meta-analysis","volume":"111","author":"Wu","year":"2018","journal-title":"Bone"},{"key":"2024021014483649100_jbmr3699-bib-0016","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1002\/jbmr.3557","article-title":"Comparing Strategies Targeting Osteoporosis to Prevent Fractures After an Upper Extremity Fracture (C-STOP Trial): a randomized controlled trial","volume":"33","author":"Majumdar","year":"2018","journal-title":"J Bone Miner Res"},{"key":"2024021014483649100_jbmr3699-bib-0017","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1503\/cmaj.070981","article-title":"Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial","volume":"178","author":"Majumdar","year":"2008","journal-title":"CMAJ"},{"key":"2024021014483649100_jbmr3699-bib-0018","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1210\/jc.2013-1034","article-title":"Cost-effectiveness of two inexpensive postfracture osteoporosis interventions: results of a randomized trial","volume":"98","author":"Majumdar","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"2024021014483649100_jbmr3699-bib-0019","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1007\/s00198-017-3986-3","article-title":"Beaupre LA; for the STOP-Fracture PRIHS Team. Economic evaluation of a population-based osteoporosis intervention for outpatients with non-traumatic non-hip fractures: the 'Catch a Break' 1i [type C] FLS","volume":"28","author":"Majumdar","year":"2017","journal-title":"Osteoporos Int"},{"key":"2024021014483649100_jbmr3699-bib-0020","doi-asserted-by":"crossref","first-page":"305","DOI":"10.2165\/00019053-200321050-00002","article-title":"Cost effectiveness of alendronate (fosamax) for the treatment of osteoporosis and prevention of fractures","volume":"21","author":"Johnell","year":"2003","journal-title":"Pharmacoeconomics"},{"key":"2024021014483649100_jbmr3699-bib-0021","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1177\/0272989X9301300409","article-title":"Markov models in medical decision making: a practical guide","volume":"13","author":"Sonnenberg","year":"1993","journal-title":"Med Decis Making"},{"key":"2024021014483649100_jbmr3699-bib-0022","author":"Strom","year":"2018"},{"key":"2024021014483649100_jbmr3699-bib-0023","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1007\/s001980170036","article-title":"Challenges for model-based economic evaluations of postmenopausal osteoporosis interventions","volume":"12","author":"Tosteson","journal-title":"Osteoporos Int. 2001"},{"key":"2024021014483649100_jbmr3699-bib-0024","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s00198-006-0257-0","article-title":"Cost-effectiveness of the treatment and prevention of osteoporosis\u2014a review of the literature and a reference model","volume":"18","author":"Zethraeus","year":"2007","journal-title":"Osteoporos Int"},{"key":"2024021014483649100_jbmr3699-bib-0025","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s00198-006-0248-1","article-title":"Persistence, reproducibility, and cost-effectiveness of an intervention to improve the quality of osteoporosis care after a fracture of the wrist: results of a controlled trial","volume":"18","author":"Majumdar","year":"2007","journal-title":"Osteoporos Int"},{"key":"2024021014483649100_jbmr3699-bib-0026","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1007\/s00198-010-1412-1","article-title":"Cost-effectiveness of a multifaceted intervention to improve quality of osteoporosis care after wrist fracture","volume":"22","author":"Majumdar","year":"2011","journal-title":"Osteoporos Int"},{"key":"2024021014483649100_jbmr3699-bib-0027","doi-asserted-by":"crossref","first-page":"637","DOI":"10.7326\/0003-4819-148-9-200805060-00003","article-title":"Relative effectiveness of osteoporosis drugs for preventing nonvertebral fracture","volume":"148","author":"Cadarette","year":"2008","journal-title":"Ann Intern Med"},{"key":"2024021014483649100_jbmr3699-bib-0028","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1210\/er.2001-9002","article-title":"Rosen C; Osteoporosis Methodology Group and The Osteoporosis Research Advisory Group. Meta-analyses of therapies for postmenopausal osteoporosis. IX: Summary of meta-analyses of therapies for postmenopausal osteoporosis","volume":"23","author":"Cranney","year":"2002","journal-title":"Endocr Rev"},{"key":"2024021014483649100_jbmr3699-bib-0029","doi-asserted-by":"crossref","first-page":"197","DOI":"10.7326\/0003-4819-148-3-200802050-00198","article-title":"Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis","volume":"148","author":"MacLean","year":"2008","journal-title":"Ann Intern Med"},{"key":"2024021014483649100_jbmr3699-bib-0030","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1056\/NEJMoa030897","article-title":"Ten years\u2019 experience with alendronate for osteoporosis in postmenopausal women","volume":"350","author":"Bone","year":"2004","journal-title":"N Engl J Med"},{"key":"2024021014483649100_jbmr3699-bib-0031","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1001\/jama.2016.12195","article-title":"Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: Second Panel on Cost-Effectiveness in Health and Medicine","volume":"316","author":"Sanders","year":"2016","journal-title":"JAMA"},{"key":"2024021014483649100_jbmr3699-bib-0032","year":"2015"},{"key":"2024021014483649100_jbmr3699-bib-0033","year":"2015"},{"key":"2024021014483649100_jbmr3699-bib-0034","doi-asserted-by":"crossref","first-page":"734","DOI":"10.7326\/0003-4819-142-9-200505030-00008","article-title":"Cost-effectiveness of alendronate therapy for osteopenic postmenopausal women","volume":"142","author":"Schousboe","year":"2005","journal-title":"Ann Intern Med"},{"key":"2024021014483649100_jbmr3699-bib-0035","year":"2015"},{"key":"2024021014483649100_jbmr3699-bib-0036","year":"2019"},{"key":"2024021014483649100_jbmr3699-bib-0037","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1002\/jbmr.5650070214","article-title":"Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985-1989","volume":"7","author":"Cooper","year":"1992","journal-title":"J Bone Miner Res"},{"key":"2024021014483649100_jbmr3699-bib-0038","year":"2013"},{"key":"2024021014483649100_jbmr3699-bib-0039","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s00198-009-0844-y","article-title":"An updated systematic review of Health State Utility Values for osteoporosis related conditions","volume":"20","author":"Peasgood","year":"2009","journal-title":"Osteoporos Int"},{"key":"2024021014483649100_jbmr3699-bib-0040","doi-asserted-by":"crossref","first-page":"2762","DOI":"10.1210\/jc.2011-0575","article-title":"The economics of improving medication adherence in osteoporosis: validation and application of a simulation model","volume":"96","author":"Patrick","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"2024021014483649100_jbmr3699-bib-0041","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1210\/jc.2009-0852","article-title":"Effect of osteoporosis treatment on mortality: a meta-analysis","volume":"95","author":"Bolland","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"2024021014483649100_jbmr3699-bib-0042","year":"2016"},{"key":"2024021014483649100_jbmr3699-bib-0043","author":"Zethraeus"},{"key":"2024021014483649100_jbmr3699-bib-0044","doi-asserted-by":"crossref","first-page":"2110","DOI":"10.1001\/archinte.167.19.2110","article-title":"Use of a case manager to improve osteoporosis treatment after hip fracture: results of a randomized controlled trial","volume":"167","author":"Majumdar","year":"2007","journal-title":"Arch Intern Med"},{"key":"2024021014483649100_jbmr3699-bib-0045","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1001\/archinte.169.1.25","article-title":"Osteoporosis case manager for patients with hip fractures: results of a cost-effectiveness analysis conducted alongside a randomized trial","volume":"169","author":"Majumdar","year":"2009","journal-title":"Arch Intern Med"},{"key":"2024021014483649100_jbmr3699-bib-0046","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s00198-010-1212-7","article-title":"Nurse case-manager vs multifaceted intervention to improve quality of osteoporosis care after wrist fracture: randomized controlled pilot study","volume":"22","author":"Majumdar","year":"2011","journal-title":"Osteoporos Int"},{"key":"2024021014483649100_jbmr3699-bib-0047","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1002\/art.24097","article-title":"Facilitated bone mineral density testing versus hospital-based case management to improve osteoporosis treatment for hip fracture patients: additional results from a randomized trial","volume":"61","author":"Morrish","year":"2009","journal-title":"Arthritis Rheum"},{"issue":"11","key":"2024021014483649100_jbmr3699-bib-0048","doi-asserted-by":"crossref","first-page":"818","DOI":"10.7326\/M15-1361","article-title":"Treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical practice guideline update from the American College of Physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med"},{"issue":"6","key":"2024021014483649100_jbmr3699-bib-0049","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1002\/jbmr.35","article-title":"Time since prior fracture is a risk modifier for 10-year osteoporotic fractures","volume":"25","author":"Giangregorio","year":"2010","journal-title":"J Bone Miner Res"},{"key":"2024021014483649100_jbmr3699-bib-0050","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s00198-018-4702-7","article-title":"Adherence to osteoporosis therapy after an upper extremity fracture: a pre-specified substudy of the C-STOP randomized controlled trial","volume":"30","author":"McAlister","year":"2019","journal-title":"Osteoporos Int"}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjbmr.3699","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jbmr.3699","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jbmr.3699","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/34\/7\/1220\/56656381\/jbmr3699.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/34\/7\/1220\/56656381\/jbmr3699.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T15:03:37Z","timestamp":1710342217000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/34\/7\/1220-1228\/7606063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,19]]},"references-count":50,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,2,19]]},"published-print":{"date-parts":[[2019,7,1]]}},"URL":"https:\/\/doi.org\/10.1002\/jbmr.3699","relation":{},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,7,1]]},"published":{"date-parts":[[2019,2,19]]},"assertion":[{"value":"2018-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}