Undertreatment of osteoporosis following hip fracture: a retrospective, observational study in Singapore

Chau, Yi Ting; Nashi, Nazrul; Law, Lawrence Siu-Chun; Goh, Raymond Kai Heng; Choo, Selena Xueli; Seetharaman, Santhosh Kumar

doi:10.1007/s11657-020-00816-2

Cited by 18 publications

(16 citation statements)

References 38 publications

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“…In our population, male patients presenting with fractures and treated with osteoporosis medications were very low. This finding is similar to previous reports which are partially explained due to underdiagnosed and under-treatment of males for osteoporosis [20,21].…”

Section: Discussionsupporting

confidence: 92%

Retrospective analysis of the use of osteoporosis medication at the presentation of fragility fractures in a predominantly Hispanic population

Torres-Reverón

Serra-Torres

2020

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Despite the high incidence of osteoporosis, many patients at risk of fragility fractures may not initiate treatment due to concerns about side effects, or cost. We aimed to identify whether the patient population presenting with fragility fractures is receiving prophylactic treatment for osteoporosis within a single academic hospital in the southernmost region of the United States. This region is characterized by a high number of patients from Hispanic/Latino heritage (80%) and reduced access to healthcare services. We conducted a three-year, retrospective cohort study of patients presenting with low impact fractures of the humerus or the shoulder griddle, lower end of radius or ulna and forearm, hip fractures (femoral neck, intertrochanteric/subtrochanteric), the lower end of tibia, medial malleolus, lateral malleolus or lower leg. Male and female subjects of 50 years or older were included. Demographic data and information on medications reported at fracture presentation were extracted from electronic medical records. We found that 42% of the patients were taking at least one medication to prevent osteoporosis. The predominant combination was vitamin D plus calcium and bisphosphonates. If patients taking only vitamin D plus calcium are excluded, 16.7% of the sample took osteoporosis medications at the fragility fracture presentation. The likelihood of taking osteoporosis medication was increased by age and type of health insurance (Medicare/private insurance), and concomitant diagnosis of impaired gait and mobility. The percentage of the patients taking prophylactic medications for osteoporosis at the time of a fragility fracture was comparable to reported national standards and associated with increased age and health insurance coverage. In a predominantly Hispanic/Latino patient population living in a medically underserved region, there is substantial recognition and prevention strategies for osteoporosis.

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Section: Discussionsupporting

confidence: 92%

Retrospective analysis of the use of osteoporosis medication at the presentation of fragility fractures in a predominantly Hispanic population

Torres-Reverón

Serra-Torres

2020

Preprint

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“…Its use in Singapore has increased significantly in the last 2 years, and it is the most often prescribed injectable therapy for osteoporosis in the country currently. Intravenous zoledronic acid and subcutaneous daily teriparatide are much less frequently used [ 1 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Adherence to dosing schedule of denosumab therapy for osteoporosis during COVID-19 lockdown: an electronic medical record and pharmacy claims database study from Asia

et al. 2021

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“…Despite its high prevalence, association with increased morbidity and mortality, osteoporosis remains underdiagnosed and under-treated [9]. Barriers which impede the delivery of optimal osteoporosis care and prevention include patient-, physician-, and healthcare system-related factors.…”

Section: Introductionmentioning

confidence: 99%

Osteoporosis awareness among patients in Singapore (OASIS)—a community hospital perspective

2021

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This study examines factors associated with osteoporosis awareness and knowledge using Osteoporosis Prevention and Awareness Tool (OPAAT). Of 410 patients, majority of patients had a OPAAT score < 24 (n = 362, 88.3%). Lower education level (odds ratio (OR) (primary education): 3.63; OR (no formal education): 111.5; p < 0.001) and diabetic patients (OR: 1.67; p = 0.003) were associated with lower OPAAT scores. Introduction Lack of osteoporosis awareness forms a critical barrier to osteoporosis care and has been linked with increased institutionalization, healthcare expenditures, and decreased quality of life. This study aims to identify factors associated with osteoporosis awareness and knowledge among female Singaporeans. Methodology A cross-sectional study was conducted among adult female patients (aged 40 to 90 years old) who were admitted into Outram Community Hospital from April to October 2020. Osteoporosis awareness and knowledge were assessed using interviewer-administered Osteoporosis Prevention and Awareness Tool (OPAAT). High knowledge was defined as a OPAAT score ≥ 24. Multivariate logistical regression analyses were used to identify predictors of low OPAAT scores. Results Of 410 patients recruited, their mean age was 71.9 ± 9.5 years old and majority of patients had a OPAAT score < 24 (n = 362, 88.3%). Patients with lower OPAAT scores tended to be older (72.5 ± 9.2 vs 67.5 ± 10.1, p < 0.001), attained lower education level (p < 0.001), and were more likely to live in public housing (92.5% vs 81.5%, p = 0.009). The prevalence of diabetes mellitus was higher in patients with low OPAAT scores (39.2% vs 18.8%, p = 0.006). After adjustment for covariates, lower education level (odds ratio (OR) (primary education): 3.63; OR (no formal education): 11.5; p < 0.05) and patients with diabetes mellitus (OR: 1.67; p = 0.03) were associated with lower OPAAT knowledge scores. Conclusion Elderly female patients in community hospital have inadequate osteoporosis awareness despite being at risk of fractures. There is a need to address the knowledge gap in osteoporosis, especially among diabetic patients or patients with lower education.

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Undertreatment of osteoporosis following hip fracture: a retrospective, observational study in Singapore

Cited by 18 publications

References 38 publications

Retrospective analysis of the use of osteoporosis medication at the presentation of fragility fractures in a predominantly Hispanic population

Retrospective analysis of the use of osteoporosis medication at the presentation of fragility fractures in a predominantly Hispanic population

Adherence to dosing schedule of denosumab therapy for osteoporosis during COVID-19 lockdown: an electronic medical record and pharmacy claims database study from Asia

Osteoporosis awareness among patients in Singapore (OASIS)—a community hospital perspective

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