Osteoporosis Fracture Prevention (OPTIONS) program to support recovery after a broken hip or leg.

Effectiveness of an Multi-Modal Intervention for Transitions of Care After Lower Limb Fracture

This project tests whether a combined program of tailored exercise, healthy nutrition, and bone‑strengthening medicines with clinician decision support helps people 65+ who break a hip or leg recover in a skilled nursing facility and avoid future fractures.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 1344 (estimated)
• Ages: 65 Years and up
• Sex: All
• Sponsor: Brigham and Women's Hospital (other)
• Locations: 2 sites (Baltimore, Maryland and 1 other locations)
• Trial ID: NCT06731608 on ClinicalTrials.gov

What this trial studies

Investigators will introduce OPTIONS, an integrated multi‑modal intervention that uses clinical decision support for clinicians and tailored education for patients and care partners to increase use of exercise, nutrition, and osteoporosis medications during and after skilled nursing facility (SNF) rehabilitation. The program targets older adults who were living in the community before a lower‑limb fragility fracture and who are admitted to participating SNFs for rehabilitation with an expected discharge back to the community. Implementation will be done in partnership with health‑IT systems (including PointClickCare) to deliver decision support and coordinate care across the SNF and transition home. Outcomes include uptake and sustained use of evidence‑based interventions and improved recovery and fracture prevention across the care transition.

Who should consider this trial

Good fit: Ideal candidates are community‑dwelling adults aged 65 or older who are admitted to a participating SNF for rehabilitation after a lower‑limb fragility fracture and are expected to discharge back to the community, are English or Spanish speakers, and have adequate cognition to participate (BIMS score >7).

Not a fit: Patients receiving hospice or end‑of‑life care, those with serious cognitive impairment (BIMS 0–7), non‑English/non‑Spanish speakers, or those with SNF stays under seven days or not expected to return to the community are unlikely to benefit from this program.

Why it matters

Potential benefit: If successful, the program could increase use of proven therapies after a hip or leg fracture, reduce future fractures, and improve recovery and independence for older adults.

How similar studies have performed: Components such as exercise, nutrition, and osteoporosis medications have shown benefit in prior studies, but embedding them via clinical decision support across SNFs and transitions is a relatively novel approach.

Eligibility criteria

Inclusion Criteria:

* Age ≥65 years old
* Community-dwelling at the time of fracture
* Admission to a participating SNF for rehabilitation following a lower limb fragility fracture, including pelvic fractures
* Expected discharge to the community (home or assisted living)

Exclusion Criteria:

* Not English or Spanish speaker
* Admission Brief Interview for Mental Status (BIMS) score 0-7
* SNF length of stay \< 7 days
* Regular access to a working telephone or other communication device
* Receiving hospice or end-of-life care

Where this trial is running

Baltimore, Maryland and 1 other locations

• University of Maryland, Baltimore, Department of Epidemiology and Public Health, Division of Gerontology — Baltimore, Maryland, United States (RECRUITING)
• Brigham and Women's Hospital — Boston, Massachusetts, United States (RECRUITING)

Study contacts

• Principal investigator: Denise Orwig, PhD — University of Maryland, Baltimore
• Study coordinator: Patricia Dykes, RN, PhD

Conditions: Osteoporosis, Lower Limb Fracture, Post-fracture Care, Fracture Prevention