Osteoporosis International

, Volume 18, Issue 12, pp 1633–1639

Successful direct intervention for osteoporosis in patients with minimal trauma fractures

  • I. Kuo
  • C. Ong
  • L. Simmons
  • D. Bliuc
  • J. Eisman
  • J. Center
Original Article

DOI: 10.1007/s00198-007-0418-9

Cite this article as:
Kuo, I., Ong, C., Simmons, L. et al. Osteoporos Int (2007) 18: 1633. doi:10.1007/s00198-007-0418-9

Abstract

Summary

In this study, we offered osteoporosis investigation and treatment directly to patients at out-patient fracture clinics shortly after they sustained minimal trauma fractures. We achieved long-term compliance to the recommended investigation and treatment in 80% of patients. This approach is much more successful than previous interventions.

Introduction

Osteoporosis remains under-treated in minimal-trauma fracture subjects. The aim of this study was to determine if direct intervention at orthopaedic fracture clinics would improve post-fracture management in these subjects.

Methods

From March 2004 to March 2006, 155 consecutive minimal-trauma fracture subjects (mean age 64.0 ± 17.6) attending fracture clinics at St. Vincent’s Hospital, Sydney, had a specific medical assessment, following which they were recommended BMD and laboratory testing. Treatment recommendations were given after review of investigations with further follow-up at a median of 8.6 months following therapy. Comparison of outcomes was made with a similar group of patients given written information 2 years prior.

Results

At baseline, 47% of patients had prior fractures, but only 26% had had BMD screening. Twenty-one percent were on anti-resorptive therapy, and 15% were on calcium/vitamin D. Following intervention, 83% had a BMD and of these, 68% had a T-score < −1.0. Of treatment naïve patients, 44% were recommended anti-resorptive therapy and 56% were recommended calcium/vitamin D. Compliance was 80% for anti-resorptive and 76% for calcium/vitamin D. Female gender and lower BMD were predictors of compliance.

Conclusion

Compared with information-based intervention, direct intervention improved management two to fivefold, maintaining long-term treatment in 90% of osteoporotic and 73% of osteopenic subjects requiring therapy.

Keywords

Compliance Fracture clinic intervention Fragility fracture Minimal trauma Osteoporosis Secondary prevention 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • I. Kuo
    • 1
    • 2
    • 4
  • C. Ong
    • 1
  • L. Simmons
    • 1
  • D. Bliuc
    • 1
    • 3
  • J. Eisman
    • 1
    • 2
    • 3
  • J. Center
    • 1
    • 2
  1. 1.Bone and Mineral Research ProgramGarvan Institute of Medical ResearchSydneyAustralia
  2. 2.St. Vincent’s HospitalSydneyAustralia
  3. 3.University of New South WalesSydneyAustralia
  4. 4.Bone and Mineral Research ProgramGarvan Institute of Medical ResearchDarlinghurstAustralia

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