Original Article

Osteoporosis International

, Volume 16, Issue 9, pp 1079-1085

Improving osteoporosis management in patients with fractures

  • S. L. JohnsonAffiliated withEndocrinology Section, McGuire Veterans Affairs Medical CenterVirginia Commonwealth University School of Pharmacy
  • , V. I. PetkovAffiliated withMcGuire Research Institute Inc.Department of Preventive Medicine and Community Health, Virginia Commonwealth University School of Medicine
  • , M. I. WilliamsAffiliated withEndocrinology Section, McGuire Veterans Affairs Medical CenterVirginia Commonwealth University School of Pharmacy
  • , P. S. ViaAffiliated withEndocrinology Section, McGuire Veterans Affairs Medical Center
  • , Robert A. AdlerAffiliated withEndocrinology Section, McGuire Veterans Affairs Medical CenterDepartment of Preventive Medicine and Community Health, Virginia Commonwealth University School of MedicineDepartment of Internal Medicine, Virginia Commonwealth University School of MedicineMcGuire VAMC (111P) Email author 

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Abstract

A history of fracture is an independent risk factor for future fractures, but patients who have sustained a fracture are rarely evaluated for osteoporosis (OP). The objective of this study was to determine if a simple intervention in a general orthopedic clinic would lead to more fracture patients receiving evaluation and treatment for OP. Patients with a history of fracture visiting a weekly orthopedic clinic during a 6-month intervention period were educated about OP, and a bone mineral density (BMD) test was offered. The number of BMD tests performed and other OP-specific actions taken as a result of the intervention were compared with a 6-month pre-intervention period. The prevalence of OP in those who underwent BMD testing was examined. In the pre-intervention period, only 12.7% (16 of 126) had a BMD test as compared with 62.5% of the 136 intervention-period subjects (odds ratio [OR] 11.5, 95% confidence interval [CI] 6.1, 21.4). Based on BMD test results, 11.9% of the pre-intervention patients, and 41.9% of the intervention patients received OP-specific recommendations (OR 5.3, 95% CI 2.8, 10.1). The intervention led to more patients being treated for low bone mass (9.5% vs 23.5%); OR 2.9, 95% CI 1.4, 5.9. Low bone mass was common among all types of fracture patients: 20% had osteoporosis and 41%, osteopenia. BMD testing in patients with fractures should identify those at risk for future fractures, leading to appropriate treatment.

Keywords

Bone densitometry Fractures Osteoporosis