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Few fragility fracture patients perceive that their bone health is affected by their comorbidities and medications

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Abstract

Summary

We examined fragility fracture patients’ perceptions of associations between bone health and other chronic conditions and medications. Awareness of the associations between bone health and these conditions and medications was low. Providers should increase patients’ awareness of these associations in order to minimize the risk of future fracture.

Introduction

Among patients with a fragility fracture presenting with at least one other chronic health condition, we examined (1) perceptions of the association between bone health and their other health conditions, and (2) perceptions of the association between bone health and prescribed medications taken for other health conditions.

Methods

We identified fragility fracture patients presenting to a Canadian urban fracture clinic with at least one self-reported chronic health condition (in addition to bone fragility). In-depth interviews, 60–90 min in duration, were conducted. Our qualitative methodology was informed by saliency analysis.

Results

We interviewed 26 patients (21 females, 5 males) aged 45 to 84 years old. Participants were taking 1–13 medications each and presented with a variety of comorbidities (range 1–7). All participants described at least one condition or medication they were currently taking for which there existed evidence of a negative effect on bone health (increased risk of fracture, bone loss, falling). Two participants perceived a correct association between their other health conditions and compromised bone health, and four participants perceived a correct association between their medications and compromised bone health.

Conclusion

All patients reported a chronic health condition and/or were taking at least one medication that potentially compromised their bone health. Patient awareness of the association between bone health and other health conditions and prescribed medications was low. Health care providers should increase patients’ awareness of the bone health significance of their chronic conditions and medications in order to minimize the risk of future fracture.

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Acknowledgments

Funding for this project was provided by the Canadian Institutes of Health Research (MOP – 136934). Joanna Sale held a Canadian Institutes of Health Research New Investigator Salary Award (Funding Reference Number COB-136622) at the time the manuscript was submitted.

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Authors and Affiliations

  1. Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada

    J.E.M. Sale, L. Frankel & V. Elliot-Gibson

  2. Institute of Health Policy, Management & Evaluation, University of Toronto, 4th Floor – 155 College Street, Toronto, Ontario, M5T 3M6, Canada

    J.E.M. Sale

  3. Department of Surgery, University of Toronto, St. Michael’s Hospital, Unity Health Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada

    E. Bogoch

  4. Institute for Work & Health, Suite 800 – 481 University Avenue, Toronto, Ontario, M5G 2E9, Canada

    M. Gignac

  5. Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, Ontario, M5S 1A8, Canada

    G. Hawker

  6. Osteoporosis Canada, Suite 201 – 250 Ferrand Drive, Toronto, Ontario, M3C 3G8, Canada

    R. Jain & L. Funnell

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  1. J.E.M. Sale
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  2. L. Frankel
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Correspondence to J.E.M. Sale.

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Sale, J., Frankel, L., Bogoch, E. et al. Few fragility fracture patients perceive that their bone health is affected by their comorbidities and medications. Osteoporos Int 31, 2047–2055 (2020). https://doi.org/10.1007/s00198-020-05409-w

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  • DOI: https://doi.org/10.1007/s00198-020-05409-w

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