Initiation of osteoporosis assessment in the fracture clinic results in improved osteoporosis management: a randomised controlled trial

Queally, Joseph M.; Kiernan, Christine; Shaikh, Maliha; Rowan, Fiachra; Bennett, David

doi:10.1007/s00198-012-2238-9

Cited by 24 publications

(11 citation statements)

References 24 publications

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“…Osteoporosis which is derived from the Greek word meaning porous bone, is defined as a skeletal disease that is marked by low bone mass and structural deterioration of bone tissue, leading to disruption of bone strength and increased bone fractures [1]. Osteoporotic fractures increase a patient's morbidity and compromise quality of life by causing chronic pain, reduced mobility, depression and finally loss of independence [2].…”

Section: Introductionmentioning

confidence: 99%

The Protective Effect of Amphimas pterocarpoides Plant Extract on Bone Mineral Density and Strength in Estrogen Deficient Ovariectomized Wistar Rats

Patsaki¹,

Tchoumtchoua²,

Passali³

et al. 2016

Med Aromat Plants

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Section: Introductionmentioning

confidence: 99%

The Protective Effect of Amphimas pterocarpoides Plant Extract on Bone Mineral Density and Strength in Estrogen Deficient Ovariectomized Wistar Rats

Patsaki¹,

Tchoumtchoua²,

Passali³

et al. 2016

Med Aromat Plants

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“…A total of 4199 unique records (citations) were identified with the literature search strategies, of which 43 met inclusion criteria . A flow diagram of the literature search and inclusion/exclusion process is shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

How Can We Improve Osteoporosis Care? A Systematic Review and Meta-Analysis of the Efficacy of Quality Improvement Strategies for Osteoporosis

Nayak

Greenspan

2018

Journal of Bone and Mineral Research

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Although osteoporosis affects 10 million people in the United States, screening and treatment rates remain low. We performed a systematic review and meta-analysis of the efficacy of quality improvement strategies to improve osteoporosis screening (bone mineral density [BMD]/dual-energy X-ray absorptiometry [DXA] testing) and/or treatment (pharmacotherapy) initiation rates. We developed broad literature search strategies for PubMed, Embase, and Cochrane Library databases, and applied inclusion/exclusion criteria to select relevant studies. Random-effects meta-analyses were performed for outcomes of BMD/DXA testing and/or osteoporosis treatment. Forty-three randomized clinical studies met inclusion criteria. For increasing BMD/DXA testing in patients with recent or prior fracture, meta-analyses demonstrated several efficacious strategies, including orthopedic surgeon or fracture clinic initiation of osteoporosis evaluation or management (risk difference 44%, 95% confidence interval [CI] 26%-63%), fracture liaison service/case management (risk difference 43%, 95% CI 23%-64%), multifaceted interventions targeting providers and patients (risk difference 24%, 95% CI 15%-32%), and patient education and/or activation (risk difference 16%, 95% CI 6%-26%). For increasing osteoporosis treatment in patients with recent or prior fracture, meta-analyses demonstrated significant efficacy for interventions of fracture liaison service/case management (risk difference 20%, 95% CI 1%-40%) and multifaceted interventions targeting providers and patients (risk difference 12%, 95% CI 6%-17%). The only quality improvement strategy for which meta-analysis findings demonstrated significant improvement of osteoporosis care for patient populations including individuals without prior fracture was patient self-scheduling of DXA plus education, for increasing the outcome of BMD testing (risk difference 13%, 95% CI 7%-18%). The meta-analyses findings were limited by small number of studies in each analysis; high between-study heterogeneity; sensitivity to removal of individual studies; and unclear risk of bias of included studies. Despite the limitations of the current body of evidence, our findings indicate there are several strategies that appear worthwhile to enact to try to improve osteoporosis screening and/or treatment rates. © 2018 American Society for Bone and Mineral Research.

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“…52 54 55 Irish studies suggest that some patients with osteoporosis are similarly not treated, while others may be treated even in the absence of a DXA scan, fracture or high fracture risk. [56][57][58] At first glance, it appears that many patients with fractures are not on treatment. There is an opportunity in this project to explore this further.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

The Irish dual-energy X-ray absorptiometry (DXA) Health Informatics Prediction (HIP) for Osteoporosis Project

Erjiang

Wang²,

Yang

et al. 2020

BMJ Open

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PurposeThe purpose of the Irish dual-energy X-ray absorptiometry (DXA) Health Informatics Prediction (HIP) for Osteoporosis Project is to create a large retrospective cohort of adults in Ireland to examine the validity of DXA diagnostic classification, risk assessment tools and management strategies for osteoporosis and osteoporotic fractures for our population.ParticipantsThe cohort includes 36 590 men and women aged 4–104 years who had a DXA scan between January 2000 and November 2018 at one of 3 centres in the West of Ireland.Findings to date36 590 patients had at least 1 DXA scan, 6868 (18.77%) had 2 scans and 3823 (10.45%) had 3 or more scans. There are 364 unique medical disorders, 186 unique medications and 46 DXA variables identified and available for analysis. The cohort includes 10 349 (28.3%) individuals who underwent a screening DXA scan without a clear fracture risk factor (other than age), and 9947 (27.2%) with prevalent fractures at 1 of 44 skeletal sites.Future plansThe Irish DXA HIP Project plans to assess current diagnostic classification and risk prediction algorithms for osteoporosis and fractures, identify the risk predictors for osteoporosis and develop novel, accurate and personalised risk prediction tools, by using the large multicentre longitudinal follow-up cohort. Furthermore, the dataset may be used to assess, and possibly support, multimorbidity management due to the large number of variables collected in this project.

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Initiation of osteoporosis assessment in the fracture clinic results in improved osteoporosis management: a randomised controlled trial

Cited by 24 publications

References 24 publications

The Protective Effect of Amphimas pterocarpoides Plant Extract on Bone Mineral Density and Strength in Estrogen Deficient Ovariectomized Wistar Rats

The Protective Effect of Amphimas pterocarpoides Plant Extract on Bone Mineral Density and Strength in Estrogen Deficient Ovariectomized Wistar Rats

How Can We Improve Osteoporosis Care? A Systematic Review and Meta-Analysis of the Efficacy of Quality Improvement Strategies for Osteoporosis

The Irish dual-energy X-ray absorptiometry (DXA) Health Informatics Prediction (HIP) for Osteoporosis Project

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