RCHC Community Project Abstracts

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Screening for Osteoporosis: Is there consensus?
Date of project: 4/25/2005

Osteoporosis is a significant factor in the health care needs of the aging population. Since one-half of all postmenopausal will suffer an osteoporosis-related fracture in their life time, it seems reasonable to screen women before they experience a fracture and begin treatment for those at the highest risk. This strategy seems very reasonable considering the effective treatments available to combat the bone loss. There are several modalities for screening women that are universally accepted, but they are not without cost to the health system. There are some published criteria for screening women age 65 or greater, and those less than 65 years with a history of fracture. However, women began to lose bone density at about 35 years old, so when is it acceptable to begin testing bone mineral density? There are several risk factor assessment tools for selective screening: the SCORE, ORAI, ABONE, NOF recommendations. A screening test needs to be highly sensitive to pick up those at highest risk, with the greatest specificity. The ORAI seems to meet these criteria. Some suggest the NOF recommendations as their preferred assessment tool, which seems very reasonable, but I feel the simplicity of the ORAI and the better operating characteristics make it preferable.

Weight Loss Support Group
Date of project: 3/21/2005

Obesity has become one of the most problematic medical conditions currently faced in the United States as well as Oregon. Obesity raises the risk of morbidity from several life threatening conditions, however that risk may be reduced with weight loss. The purpose of this study is to improve the effectiveness of treating obesity in the setting of the Rinehart Clinic in Wheeler, Oregon. Observation of a family practitioner and patient interviews were the primary sources of patient information about dieting effectiveness and patient resources. A diet plan which included educational materials was readily available in the clinic, but no further information or support source was identified in this community. Evidence exists that social support dramatically increases the amount of weight loss as well as the ability to keep weight off. Therefore, a weekly weight loss support group was established as a social support network for patients trying to lose weight.

Hepatitis C Virus Treatment Program
Date of project: 9/13/2004

There are currently no available locate treatment programs to offer patients infected with the hepatitis C virus (HCV) living on the northern Oregon coast. The majority of patients infected with HCV, from Pacific City up to Astoria, have to drive into the Willamette Valley in order to receive treatment program at the Rinehart Clinic in Wheeler, Oregon. Materials were developed based on need for patient education materials, flow sheets to monitor treatment progress, and a protocol for providers to refer to when beginning the treatment of a patient. Information used to develop these materials came from the 2002 NIH Consensus on the management of hepatitis C, researched articles, and an established hepatitis C treatment program in the Willamette Valley. Patients needing treatment were identified by clinic records. The materials developed were reviewed by the physician and found to meet the clinic's needs for establishing a hepatitis C treatment program.

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