e conducted a cluster randomized controlled trial to evaluate
the effectiveness of our intervention to increase appropriate
osteoporosis treatment rates. This study was approved
by the Institutional Review Board at the University of Alabama
at Birmingham and registered at clinicaltrials.gov
(NCT00679198).
Randomization of home health care field offices
Alacare Home Health and Hospice is a nonprofit home
health care agency that provides home health and hospice
services throughout the state of Alabama. All of their offices
participated in this study, expect for office that delivers only
hospice care. Using baseline data from the 12 months prior
to project initiation, field offices were stratified based on
case volume of patients with a fracture history and rates of
prescription osteoporosis treatment among these patients
and then randomized to either the intervention or usual care
arms. Specifically, the offices were stratified into groups
based on numbers of fracture patients (at or above and
below the median of 19 patients) and the proportion of
treated patients (above and at or below the median of
13 % receiving prescription osteoporosis medications), and
then offices were randomly selected within each of these
four strata.