Skip to main content
SpringerLink
Log in

Interventions to improve inpatient osteoporosis management following first osteoporotic fracture: the PREVENT project

  • Osteoporotic Fracture Management
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Objectives

To establish a protocol for the treatment of fragility fractures in the hospital setting based on treatment of osteoporosis.

Materials and methods

An intervention protocol was implemented in patients with fragility fractures based on (1) indicating the diagnosis of osteoporotic fracture in the summary of discharge; (2) “lifestyle recommendations”; and (3) therapy for osteoporosis. Thirty-one hospitals were involved and they were informed of the importance of protocol compliance. In the first phase, a retrospective study was conducted to establish the number of low-energy fractures treated and the percentage of them that had complied with the protocol (n = 887). Then, prospectively, the same data were collected for the patients managed for 1 year (n = 6,826) in three sections of 4-month intervals.

Results

The percentage of compliance increased from 8.2 to 57.2% in the first point, from 12.6 to 42.4% in the second, and from 10.3 to 43.2% in the third.

Conclusion

The implementation of programs to improve osteoporosis treatment is very useful for ensuring adherence in the management of osteoporosis following admission due to fragility fracture.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348:1535–1541

    Article  PubMed  CAS  Google Scholar 

  2. Bogoch ER, Elliot-Gibson V, Beaton DE, Jamal S, Josse RG, Murray TM (2006) Effective initiation of osteoporosis diagnosis and treatment for patients with a fragility fracture in an orthopaedic environment. J Bone Joint Surg Am 88:25–33

    Article  PubMed  Google Scholar 

  3. Center JR, Bliuc D, Nguyen TV, Eisman JA (2007) Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 297:387–394

    Article  PubMed  CAS  Google Scholar 

  4. Charalambous CP, Kumar S, Tryfonides M, Rajkumar P, Hirst P (2002) Management of osteoporosis in an orthopaedic department: audit improves practice. Int J Clin Pract 56:620–621

    PubMed  CAS  Google Scholar 

  5. Chevalley T, Hoffmeyer P, Bonjour JP, Rizzoli R (2002) An osteoporosis clinical pathway for the medical management of patients with low-trauma fracture. Osteoporos Int 13:450–455

    Article  PubMed  CAS  Google Scholar 

  6. Cranney A, Guyatt G, Griffith L, Wells G, Tugwell P, Rosen C, The Osteoporosis Methodology Group, The Osteoporosis Research Advisory Group (2002) IX. Summary of meta-analyses of therapies for postmenopausal osteoporosis. Endocr Rev 23:570–578

    Article  PubMed  CAS  Google Scholar 

  7. Cuddihy MT, Amadio PC, Gabriel SE, Pankratz VS, Kurland RL, Melton LJIII (2004) A prospective clinical practice intervention to improve osteoporosis management following distal forearm fracture. Osteoporos Int 15:695–700

    Article  PubMed  Google Scholar 

  8. Diamond T, Lindenberg M (2002) Osteoporosis detection in the community: are patients adequately managed? Aust Fam Physician 31:751–752

    PubMed  Google Scholar 

  9. Dreinhöfer KE, Anderson M, Feron JM, Herrera A, Hube R, Johnell O, Lidgren L, Miles K, Tarantino U, Simpson H, Wallace W (2005) Multinational survey of osteoporotic fracture management. Osteoporos Int 16(Suppl 2):S44–S53

    Article  PubMed  Google Scholar 

  10. Elliot-Gibson V, Bogoch ER, Jamal SA, Beaton DE (2004) Practice patterns in the diagnosis and treatment of osteoporotic after a fragility fracture: a systematic review. Osteoporos Int 15:767–778

    Article  PubMed  CAS  Google Scholar 

  11. Hawker G, Ridout R, Ricupero M, Jaglal S, Bogoch E (2003) The impact of a simple fracture clinic intervention in improving the diagnosis and treatment of osteoporosis in fragility fracture patients. Osteoporos Int 14:171–178

    Article  PubMed  Google Scholar 

  12. Holder KK, Kerey SS (2008) Alendronate for fracture prevention in postmenopause. Am Fam Physician 78:579–581

    PubMed  Google Scholar 

  13. Kaufman JD, Bolander ME, Bunta AD, Edwards BJ, Fitzpatrick LA, Siminelli C (2003) Barriers and solutions to osteoporosis care in patients with a hip fracture. J Bone Joint Surg Am 85:1837–1843

    PubMed  Google Scholar 

  14. Keen R (2003) Burden of osteoporosis and fractures. Curr Osteoporos Rep 1:66–70

    Article  PubMed  Google Scholar 

  15. Liel Y, Castel H, Bonneh DY (2003) Impact of subsidizing effective anti-osteoporosis drugs on compliance with management guidelines in patients following low-impact fractures. Osteoporos Int 14:490–495

    Article  PubMed  CAS  Google Scholar 

  16. Lopez-Herce Cid JA, del Castillo Rueda A, Teigell Garcia L, Garrido Cantarero G, de Portugal Alvarez J (2001) Osteoporosis in patients admitted to an internal medicine service of a university general hospital. An Med Interna 18:121–123

    PubMed  CAS  Google Scholar 

  17. Majumdar SR, Beaupre LA, Harley CH, Hanley DA, Lier DA, Juby AG, Maksymowych WP, Cinats JG, Bell NR, Morrish BW (2007) Use of a case manager to improve osteoporosis treatment after hip fracture: results of a randomized controlled trial. Arch Intern Med 167:2110–2115

    Article  PubMed  Google Scholar 

  18. NIH consensus guidelines: osteoporosis prevention, diagnosis, and therapy (2000) NIH Consens Statement 17:1–45

    Google Scholar 

  19. NOF physician’s guide to prevention and treatment of osteoporosis (1999) National Osteoporosis Foundation, Washington

  20. Orsini LS, Rousculp MD, Long SR, Wang S (2005) Health care utilization and expenditures in the United States: a study of osteoporosis-related fractures. Osteoporos Int 16:359–371

    Article  PubMed  Google Scholar 

  21. Pal B, Morris J, Muddu B (1998) The management of osteoporotic-related fractures: a survey of orthopaedic surgeons practice. Clin Exp Rheumatol 16:61–62

    PubMed  CAS  Google Scholar 

  22. Port L, Center J, Briffa NK, Nguyen T, Cumming R, Eisman J (2003) Osteoporotic fracture: missed opportunity for intervention. Osteoporos Int 14:780–784

    Article  PubMed  Google Scholar 

  23. Robinson CM, Royds M, Abraham A, McQueen MM, Court-Brown CM, Christie J (2002) Refractures in patients at least 45 years old. A prospective analysis of 22,060 patients. J Bone Joint Surg A 84:1528–1533

    Google Scholar 

  24. Sidwell AI, Wilkinson TJ, Hanger HC (2004) Secondary prevention of fractures in older people: evaluation of a protocol for the investigation and treatment of osteoporosis. Int Med J 34:129–132

    Article  CAS  Google Scholar 

  25. The National Institute for Health and Clinical Excellence (2005) Bisphosphonates (alendronate, etidronate, risedronate), selective oestrogen receptor modulators (raloxifene) and parathyroid hormone (teriparatide) for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. Technology Appraisal 87, January. www.nice.org.uk

  26. Tosi LL, Gliklich R, Kannan K, Koval KJ (2008) The American Orthopaedic Association’s “own the bone” initiative to prevent secondary fractures. J Bone Joint Surg Am 90:163–173

    Article  PubMed  Google Scholar 

  27. Wells G, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, Coyle D, Tugwell P (2008) Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev 38:1236–1240

    Google Scholar 

Download references

Acknowledgment

Financial support for this study was obtained from Merck Sharp and Dohme, Spain.

Author information

Authors and Affiliations

  1. University Hospital Reina Sofia, Mejorana 45, 14012, Cordoba, Spain

    Pedro Carpintero

  2. University Hospital La Paz, Madrid, Spain

    Enrique Gil-Garay & Luis Munuera

  3. University Hospital San Agustin, Aviles, Spain

    Daniel Hernández-Vaquero

  4. Hospital Mutua De Tarrasa, Tarrasa, Spain

    Humbert Ferrer

Authors
  1. Pedro Carpintero
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Enrique Gil-Garay
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel Hernández-Vaquero
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Humbert Ferrer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luis Munuera
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pedro Carpintero.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carpintero, P., Gil-Garay, E., Hernández-Vaquero, D. et al. Interventions to improve inpatient osteoporosis management following first osteoporotic fracture: the PREVENT project. Arch Orthop Trauma Surg 129, 245–250 (2009). https://doi.org/10.1007/s00402-008-0809-1

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-008-0809-1

Keywords

Search

Navigation