Barriers to osteoporosis prevention in perimenopausal and elderly women

Ali, Nagia S.; Twibell, K. Renee

doi:10.1016/s0197-4572(09)80009-8

Cited by 27 publications

(17 citation statements)

References 20 publications

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“…Simonelli et al 30 conducted a survey of both orthopaedic surgeons and primary care physicians, and both groups agreed that treatment falls under the domain of the primary care physician because of the medical nature of the disease and the greater likelihood of long-term follow-up by the primary physician. Other potential barriers to treatment are adverse effects and the high cost of medications, patient transportation issues, and a lack of awareness by patients and physicians of the treatment guidelines and efficacy of medications for osteoporosis following hip fracture 14,23,40,41 .…”

Section: Discussionmentioning

confidence: 99%

Interventions to Improve Osteoporosis Treatment Following Hip Fracture

Gardner,

Brophy,

Demetrakopoulos

et al. 2005

The Journal of Bone & Joint Surgery

175

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Patients who were provided with information and questions for their primary care physician about osteoporosis were more likely to receive appropriate therapeutic intervention than were patients who had not received the information and questions. Orthopaedic surgeons have a unique opportunity to improve the rate of osteoporosis treatment in the perioperative period following a hip fracture by educating patients and directing them toward channels for long-term osteoporosis management.

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Section: Discussionmentioning

confidence: 99%

Interventions to Improve Osteoporosis Treatment Following Hip Fracture

Gardner,

Brophy,

Demetrakopoulos

et al. 2005

The Journal of Bone & Joint Surgery

175

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“…There are several reasons for this: (1) the orthopaedic surgeon is already engaged with the patient and family through fracture treatment and is the one who demonstrates a link between the fracture and fracturerelated disease state; (2) patients often do not return to their primary physician until after a fracture has healed, leading to the misconception that no further intervention is required; and (3) office visit time limitations of the primary care physician due to required management of other medical comorbidities may lead to a lack of prioritization of osteoporosis management and gaps in postfracture treatment 11,[54][55][56][57][58][59] .…”

Section: Road Map For Implementationmentioning

confidence: 99%

“…This practitioner should work closely with the physician champion and is often co-located in the same office setting to facilitate patient compliance with appointments and to provide patient-centered care. However, this practitioner should also practice independently to facilitate simultaneous care by both providers 54 . The FLS coordinator may have an autonomous clinic independent of the physician champion or may independently see patients in the physician's clinic, depending on the licensing of the advanced practice practitioner.…”

Section: Road Map For Implementationmentioning

confidence: 99%

Establishing a Fracture Liaison Service: An Orthopaedic Approach

Miller

Lake

Emory

2015

The Journal of Bone and Joint Surgery

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➤ Bone health evaluations should be incorporated into care pathways for fragility fractures in all patients who are fifty years of age or older.➤ A fracture liaison service (FLS) is an established and proven method to achieve recommended standards of care for fragility fractures, including intervention for osteoporosis, secondary fracture prevention, and bone health evaluation.➤ The FLS facilitates patient care by automatically including all patients with a fragility fracture within a health-care system to provide them with the intervention that they need and to prevent avoidable fracture-related complications or readmissions.➤ An FLS functions with three key personnel: the FLS coordinator (usually an advanced practice provider), a physician champion (usually an orthopaedic surgeon), and a nurse navigator.

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“…Lack of patient knowledge about osteoporosis and hormone therapy has contributed to a lack of adherence to treatment. 38,39 Low adherence to estrogen therapy in postmenopausal women has been well documented 40 ; one retrospective study 41 revealed long-term adherence of 30%. Adherence has also been a concern with the next most commonly used pharmacological agent, bisphosphonates.…”

Section: Commentmentioning

confidence: 99%