The importance of communication in secondary fragility fracture treatment and prevention

Abstract

Communication about events, acuity and clear expectations around roles and follow-up is urgently needed to improve communication throughout the circle of care to support secondary fracture prevention. Fractures from a standing height or similar trauma in women aged 40 to 65 should be treated as suspicious fractures and followed-up to investigate the underlying bone condition. This article reports on challenges and barriers to clear communication among women, their orthopaedic surgeons and family physicians that is necessary for follow-up and prevention of future fractures.

Osteoporosis risk assessment and management in primary care: focus on quantity and quality

“…Therefore, the way of information transmission is unreliable. A similar problem is reported by Meadows in the Canadian system where a GP is not routinely informed of his/her patient's visit/admission to hospital or of treatment of fragility fracture by an orthopaedic surgeon [23]. Unavailability of diagnostic examinations and specialized therapy, particularly in smaller communities, can be considered as a less significant systemic problem.…”

Do patients perceive a link between a fragility fracture and osteoporosis?

“…The likelihood that a patient with a fragility fracture perceived themselves to be at increased risk of future fracture was much greater if they had been told that they had osteoporosis. However, the clear communication of an osteoporosis diagnosis to fragility fracture patients is inconsistent, and there is a care gap between the occurrence of a fragility fracture and osteoporosis diagnosis and treatment [ 9 , 10 , 25 ]. Interestingly, the current study demonstrated that only about one in five individuals thought their fracture was related to osteoporosis.…”

‘If it was osteoporosis, I would have really hurt myself.’ Ambiguity about osteoporosis and osteoporosis care despite a screening programme to educate fragility fracture patients

“…This is perhaps not surprising given the context in which this information was delivered – the fracture clinic. Meadows and colleagues [36] found that the episodic nature of fracture care makes communication among patients, doctors and institutions difficult, if not impossible. The fracture clinic is an extremely busy environment, and patients often do not have the time to absorb all the information they receive, including fracture care, a possible diagnosis of OP and recommendations regarding OP care.…”