Closing the gap in osteoporosis management: the critical role of primary care in bone health

Singer, Andrea; Sharma, Anita; Deignan, Cynthia; Borgermans, Liesbeth

doi:10.1080/03007995.2022.2141483

Cited by 8 publications

(3 citation statements)

References 82 publications

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“…Moreover, primary care physicians play a crucial role in patient education, emphasizing the importance of fall prevention strategies and adherence to prescribed treatments to mitigate the risk of fractures. By integrating osteoporosis management into primary care practices and providing tailored interventions, primary care physicians can effectively reduce the burden of osteoporosis-related complications in rural communities, promoting better long-term outcomes and quality of life for their patients [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

High Body Fat as a Predictor of Osteoporosis Risk in Postmenopausal Women: Insights From a Community-Based Cross-Sectional Study in Rural South India

Yuvaraja,

Daniel,

Murugan

et al. 2024

Cureus

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Introduction: Osteoporosis poses a significant health burden, particularly among postmenopausal women. While obesity in the form of BMI has been implicated in various health conditions, the relationship between waist-hip ratio (WHR) and osteoporosis remains debated. This study aims to estimate the prevalence of osteoporosis risk and explore the association between WHR and osteoporosis risk among postmenopausal women in rural South India. Methods: A community-based cross-sectional study was conducted in the Chengalpattu district of Tamil Nadu. The study enrolled 435 postmenopausal women aged 45 years and above and the data were collected on socio-demographic characteristics, anthropometric measurements, and osteoporosis risk assessment using the Osteoporosis Self-assessment Tool for Asian Women (OSTA) scale. Logistic regression analysis was performed to identify factors associated with osteoporosis risk with 95%CI. Results: The mean (SD) age of participants was 54.5 (8.6) years, 87% were married, 33% were illiterate with mean (SD) WHR of 0.88 (0.1). Around 80.5% of the participants were categorized as low risk, 16.1% as intermediate risk, and 3.5% as high risk based on OSTA scores. Older age, lower educational attainment, and higher waist-hip ratio were significantly associated with increased osteoporosis risk. Conclusion: This community-based study found a 20% osteoporosis risk among postmenopausal women using the OSTA scale, with age, lower education, and waist-hip ratio as key determinants. Early identification and interventions, particularly targeting older and obese individuals, are crucial to alleviate the burden and complications of osteoporosis.

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Section: Discussionmentioning

confidence: 99%

High Body Fat as a Predictor of Osteoporosis Risk in Postmenopausal Women: Insights From a Community-Based Cross-Sectional Study in Rural South India

Yuvaraja,

Daniel,

Murugan

et al. 2024

Cureus

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“… 17 Additionally, time constraints in clinical practice, the silent nature of osteoporosis that prevents recognition until a fracture occurs, and insufficient knowledge regarding bone health may also lead to undertreatment. 18 Even after a fracture occurs, the rate of testing and treatment remains low according to the literature, and reduced reimbursement for DXA scans in recent years may have contributed to a reduction in screening as well. 19 - 21 The objective of the study was to raise awareness regarding the high prevalence of risk factors since many are likely not yet diagnosed or treated.…”

Section: Discussionmentioning

confidence: 99%

Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational Study

Jeray,

Williams,

Wang

et al. 2023

Geriatr Orthop Surg Rehabil

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Introduction There are limited data on the management of bone health, including bone mineral density (BMD) evaluation and osteoporosis (OP) treatment, in patients undergoing elective orthopaedic surgeries. Methods This was a retrospective cohort study using administrative claims data from Symphony Health, PatientSource for patients aged ≥50 years with documented kyphoplasty/vertebroplasty (KP/VP), total knee arthroplasty (TKA), and total hip arthroplasty (THA). Risk stratification to identify patients at very high risk for fracture (VHRFx) was based on clinical practice guideline recommendations to the extent information on variables of interest were available from the claims database. Results A total of 251 919 patients met inclusion criteria: KP/VP (31 018), TKA (149 849), and THA (71 052). The majority were female (80.3%) with a mean (SD) age of 68.5 (7.5) years. Patients undergoing KP/VP were older and had a greater comorbidity burden associated with risk for falls, mobility issues, muscle weakness, and respiratory and cardiovascular diseases. In the 6 months before surgery, 11.8% of patients were tested and/or received treatment for OP. Patients undergoing KP/VP were more likely to be tested and/or treated (17.5%) than patients undergoing TKA (11.0%) or THA (10.9%). Overall, men had a lower rate of testing and/or treatment than women (4.6% vs 13.5%). In the 12 months before surgery, patients with an OP diagnosis and at VHRFx (30.8%) had a higher rate of treatment and/or testing than those without OP (11.5%), or those without OP but with a fracture in the year preceding surgery (10.2%). Conclusions Bone health management is suboptimal in patients undergoing elective orthopaedic surgeries and is worse in men than in women. Proper management of OP before and after surgery may improve outcomes.

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“…Osteoporosis has been termed a “silent disease” since its presence is often not determined until after a fracture. As such, primary care providers have a critical role in assessing bone health issues and should pay close attention when conducting wellness visits and addressing comorbidities ( Singer et al, 2023 ). Lack of primary prevention and delayed intervention of fragility fractures have been deemed costly ( Lewiecki et al, 2019 ), and elderly individuals suffering from fractures face lengthy hospitalizations, require long-term care, lose independence, and have an increased risk of mortality in the following year ( Lewiecki et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Use of Clinical Practice Guidelines and Quality Metrics to Assess Primary Care Management of Osteoporosis

Camp,

Hartos,

Atanda

2023

Gerontology and Geriatric Medicine

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Background: Clinical practice guidelines and quality measures provide recommendations for physicians addressing osteoporosis management. This study explored the alignment of osteoporosis clinical practice in a primary care geriatric clinic with recommended guidelines. Methods: This retrospective chart review included 388 patients 65 or older from a primary care geriatric clinic diagnosed with osteopenia or osteoporosis, with or without a fragility fracture. Data included history of falls and use of DXA scans, FRAX® fracture risk assessment tool, osteoporosis medication, and fall risk mitigation plans. Results: For age-related primary fracture prevention, 68% of women and 87% of men had documented DXA scans, and 45% of patients diagnosed with osteoporosis and 42% determined at high risk were prescribed osteoporosis medication. For secondary fracture prevention, 72% of women aged 67 to 85 had DXA scans and 21% were prescribed osteoporosis medication. Only 10% of patients with a history of falls had documented fall risk management plans. Conclusion: Although showing higher rates of primary and secondary prevention outcomes than did research results from general primary care, gaps were identified for high fracture risk patients and fall risk management documentation. Medical record review may not provide sufficient data to capture factors influencing decision-making for fracture prevention.

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Closing the gap in osteoporosis management: the critical role of primary care in bone health

Cited by 8 publications

References 82 publications

High Body Fat as a Predictor of Osteoporosis Risk in Postmenopausal Women: Insights From a Community-Based Cross-Sectional Study in Rural South India

High Body Fat as a Predictor of Osteoporosis Risk in Postmenopausal Women: Insights From a Community-Based Cross-Sectional Study in Rural South India

Bone Health Management in Elective Orthopaedic Surgery: A Claims-Based Observational Study

Use of Clinical Practice Guidelines and Quality Metrics to Assess Primary Care Management of Osteoporosis

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