Open Access Study protocol

Impact of a multifaceted intervention to improve the clinical management of osteoporosis. The ESOSVAL-F study

José Sanfélix-Genovés12*, Salvador Peiró1, Gabriel Sanfélix-Gimeno1, Isabel Hurtado1, Manuel Pascual de la Torre3, José Luis Trillo-Mata4 and Vicente Giner-Ruiz5

Author Affiliations

1 Centro Superior de Investigación en Salud Pública (CSISP), Valencia, Spain

2 Centro de Salud de Nazaret, Departamento de Salud 5, Agencia Valenciana de Salud, Valencia, Spain

3 Oficina de Abucasis, Agencia Valenciana de Salud, Valencia, Spain

4 Dirección General de Farmacia y Productos Sanitarios, Agencia Valenciana de Salud, Valencia, Spain

5 Centro de Salud Ciudad Jardín, Departamento de Salud 19, Agencia Valenciana de la Salud, Alicante, Spain

For all author emails, please log on.

BMC Health Services Research 2010, 10:292  doi:10.1186/1472-6963-10-292

Published: 21 October 2010



A study to evaluate the impact of a combined intervention (in-class and on-line training courses, a practicum and economic incentives) to improve anti-osteoporosis treatment and to improve recordkeeping for specific information about osteoporosis.


A before/after study with a non-equivalent control group to evaluate the impact of the interventions associated with participation in the ESOSVAL-R cohort study (intervention group) compared to a group receiving no intervention (control group). The units of analysis are medical practices identified by a Healthcare Position Code (HPC) referring to a specific medical position in primary care general medicine in a Healthcare Department of the Region of Valencia, Spain. The subjects of the study are the 400 participating "practices" (population assigned to health care professionals, doctors and/or nurses) selected by the Healthcare Departments of the Valencia Healthcare Agency for participation as associate researchers in the ESOSVAL-R study (intervention group), compared to 400 participating "practices" assigned to primary care professionals NOT selected for participation as associate researchers in the ESOSVAL-R study, who are selected on the basis of their working in the same Healthcare Centers as the practices receiving the interventions (control group). The study's primary endpoint is the appropriateness of treatment according by the Spanish National Health System guide (2010) and the National Osteoporosis Foundation (NOF, 2008) and International Osteoporosis Foundation guidance (IOF, 2008).

The study will also evaluate a series of secondary and tertiary endpoints. The former are the suitability of treatment and evaluation of the risk of fracture; and the latter are the volume of information registered in the electronic clinical records, and the evaluation of risks and the suitability of treatment.