Fracture prevention strategies in patients presenting to Australian hospitals with minimal‐trauma fractures: a major treatment gap

Abstract

Most patients presenting to Australian hospitals with minimal-trauma fracture are neither investigated nor treated for osteoporosis. As this group is at high risk of subsequent fracture, this is a missed opportunity to reduce fracture burden.

PRO-OSTEO Project (improving osteoporosis management in the acute hospital setting): a pilot single-centre study

“…This project study aimed to improve osteoporosis management as directed by the algorithm to 90% and above. Prior to intervention implementation, the treatment and assessment rates were estimated by the research pharmacist to be between 10% and 20%, which compares with previously reported rate of 12% and 10%, respectively [11]. The magnitude of change that the project was aiming to achieve was large, 70-80%.…”

“…Patients were included in this study if they had been admitted to the orthopaedic ward with a diagnosed minimal trauma fracture where a minimal trauma fracture is defined as a fracture occurring following a fall from standing height or less and excludes fractures of the head and neck and fractures resulting from motor vehicle accidents [11].…”

“…It provides a brief section of statistical facts on osteoporosis morbidity, mortality, prophylactic/treatment medication effects and rates of prescribing to highlight the previous situation of low level of assessment and treatment of osteoporosis in the hospital and community settings. The aim of the educational phase was to facilitate doctors' use of the algorithm and services provided by the osteoporosis nurse, who was introduced into Frankston Hospital practice as a response to poor results demonstrated by study conducted by Teede et al [11], and to avoid the results described by Adli et al [22] where medical staff refused to use algorithm-based approach to patient care. This method of algorithm introduction also made it consistent with the intervention employed in the study described by Polinski et al [23].…”

“…adherence to treatment [4][5][6][7][8][9][10][11][12][13][14][15]. Previous research suggests that the lack of awareness of current guidelines is one of the main obstacles to initiating therapy and that multifaceted interventions are required to improve treatment results as single interventions or basic information dissemination showed no significant increase in treatment rates [4,11,[16][17][18][19][20]. Based on these recommendations and previously identified low osteoporosis assessment and treatment rates at Frankston Hospital, a study was launched to evaluate the impact of multifaceted, algorithm-based approach to osteoporosis management in patients with minimal trauma fractures in the acute hospital setting.…”

High rate of non-treatment among osteoporotic women enrolled in a US Medicare plan

“…Previous studies have demonstrated that non-treatment of osteoporosis is common [8][9][10][11][12][13][14][15][16][17][18][19][20] , whether assessed after clinical or self-reported OP diagnosis 10,20 , before OP-related fractures 8,11,16 , or after fractures 9,[11][12][13][14][15][16][17][18][19] . Common barriers to treatment initiation include: concerns over side effects 21 including gastro-intestinal (GI) events [22][23][24][25] , cost 26 , and patient frailty 26 .…”