Osteoporosis treatment rate following hip fracture in a community hospital

Khan, Aliya; AbuAlrob, Hajar; Tariq, Farhan; Tauqir, Madiha; Zalzal, Paul; M’Hiri, Iman; Khan, Moin; Ginty, Mark; Weening, Brad

doi:10.1007/s11657-020-00861-x

Cited by 9 publications

(5 citation statements)

References 68 publications

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“…Patient data were collected from across Canada with differing osteoporosis care priorities and barriers [15]. Our data support the findings from a recently published Canadian study demonstrating that diagnosis and treatment rates of osteoporosis after a fragility fracture of the hip are alarmingly low in the absence of a formal multidisciplinary treatment program [32]. However, our study has some important limitations.…”

Section: Discussionsupporting

confidence: 79%

A retrospective observational study of osteoporosis management after a fragility fracture in primary care

et al. 2022

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Summary In many countries, osteoporosis is predominantly managed by primary care physicians; however, management after a fragility fracture has not been widely investigated. We describe osteoporosis care gaps in a real-world patient cohort. Our findings help inform initiatives to identify and overcome obstacles to effective management of patients after fragility fracture. Purpose A fragility fracture is a major risk factor for subsequent fracture in adults aged ≥ 50 years. This retrospective observational study aimed to characterize post-fracture management in Canadian primary care. Methods A total of 778 patients with an index fragility fracture (low-trauma, excluding small bones) occurring between 2014 and 2016 were identified from medical records at 76 primary care centers in Canada, with follow-up until January 2018. Results Of 778 patients (80.5% female, median age [IQR] 73 [64–80]), 215 were on osteoporosis treatment and 269 had osteoporosis diagnosis recorded prior to their index fracture. The median follow-up was 363 (IQR 91–808) days. Of patients not on osteoporosis treatment at their index fracture, 60.2% (n = 339/563) remained untreated after their index fracture and 62.2% (n = 23/37) continued untreated after their subsequent fracture. After their index fracture, fracture risk assessment (FRAX or CAROC) was not performed in 83.2% (n = 647/778) of patients, and 59.9% (n = 466/778) of patients did not receive bone mineral density testing. Of patients without osteoporosis diagnosis recorded prior to their index date, 61.3% (n = 300/489) remained undiagnosed after their index fracture. At least one subsequent fracture occurred in 11.5% (n = 86/778) of patients. Conclusion In the primary care setting, fragility fracture infrequently resulted in osteoporosis treatment or fracture risk assessment, even after multiple fragility fractures. These results suggest a fragility fracture is not recognized as a major risk factor for subsequent fracture and its occurrence does not prompt primary care physicians to intervene. These data urge initiatives to identify and overcome obstacles to primary care physicians’ effective management of patients after fragility fractures.

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Section: Discussionsupporting

confidence: 79%

A retrospective observational study of osteoporosis management after a fragility fracture in primary care

et al. 2022

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“…These findings are worrisome and demonstrate that the treatment of osteoporosis in patients after fracture, despite the numerous publications warning about the subject in the literature, remains less than ideal. ( 5 ),( 7 ),( 10 ),( 12 ),( 13 ),( 17 …”

Section: Discussionmentioning

confidence: 99%

“…( 2 ),( 5 ), ( 6 ), ( 7 ), ( 8 ), ( 9 ), ( 10 However, the lack of diagnostic accuracy and guidance of appropriate osteoporosis treatment remain high, even in patients who have already had a first osteoporotic fracture. ( 5 ),( 7 ),( 10 ), ( 11 ), ( 12 ), ( 13 …”

Section: Introductionmentioning

confidence: 99%

Do Older Patients “Warn” That They Will Suffer a New Fracture?

MELIN,

NASCIMENTO,

SANTOS NETTO

et al. 2023

Acta ortop. bras.

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Objective: To evaluate whether patients older than 60 years admitted for fracture treatment had a history of previous fracture, a diagnosis of osteoporosis, or were under treatment for bone fragility. Methods: Retrospective study including 100 patients older than 60 years with fracture. Fracture location, bone densitometry within the past two years, previous diagnosis and osteoporosis treatment, and previous fracture within the past five years were assessed. Using Fisher’s test, it was evaluated whether there was an association between previous fracture and osteoporosis treatment. Results: The most prevalent fracture was in the proximal femur (48%). Of the patients, 18% had fracture in the last five years, with 22% of them diagnosed with osteoporosis, and 22% under treatment. Previous fracture in the last five years was not associated with having a diagnosis of osteoporosis, having had bone densitometry, or being under treatment for osteoporosis. Conclusion: Among patients with previous fracture, only 22% were aware of their diagnosis of osteoporosis, and less than 25% of them were under bone fragility treatment. Previous fracture in the past five years had no association with having a diagnosis of osteoporosis, having had bone densitometry, or being on osteoporosis treatment. Level of Evidence III, Retrospective Study.

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“…The increased risk for fractures in women could be due to the deficiency of B vitamin and D vitamin, this risk is mainly seen in the hip, wrist, and spine. However, there is no link between vitamin B12 and folic acid with the risk of hip fractures (14).…”

Section: Introductionmentioning

confidence: 99%

Vitamin B status and its impact in post-menopausal women: A review

Samuel¹,

Manokaran²,

Nayak³

et al. 2022

Biomedicine

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Menopause is an age-related naturally occurring phenomenon in women. Women generally attain menopause between the 40-58 years of age, during which they undergo several physiological changes that have an impact on their daily activities. The deficiency of B vitamins occurs mainly due to the dietary pattern, absorption and blood loss which may leads to health problems such as cognitive decline, osteoporosis, physical and mental imbalance. This review evaluated the published evidence on the vitamin B status and its impact in post-menopausal women. Selected data sources were searched for relevant literature (2010-2020) and included as per the set criteria using Prisma guidelines. The NIH quality questionnaire tool was used to rate the articles. Finally eleven articles were included for full length review having reports on the impact of B vitamins on bone loss, cognitive decline and physical activity. Existing evidences show that there is no association between B vitamins and bone loss. Very few studies are available which concluded association of B vitamin with cognitive decline and physical health. More studies are required to address this research gap.

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Osteoporosis treatment rate following hip fracture in a community hospital

Cited by 9 publications

References 68 publications

A retrospective observational study of osteoporosis management after a fragility fracture in primary care

A retrospective observational study of osteoporosis management after a fragility fracture in primary care

Do Older Patients “Warn” That They Will Suffer a New Fracture?

Vitamin B status and its impact in post-menopausal women: A review

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