John Libbey Eurotext

Gériatrie et Psychologie Neuropsychiatrie du Vieillissement


A fracture - intervention program optimizes the management of osteoporosis Volume 9, issue 4, Décembre 2011


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Centre gérontologique départemental, Marseille, EA3279, Évaluation des systèmes de soins - santé perçue, Université de la Méditerranée, Marseille, Service de médecine interne et gériatrie,, Département de santé publique,, Département des urgences,, Service de chirurgie orthopédique, Centre hospitalo-universitaire Sainte Marguerite, Marseille
  • Key words: fracture-intervention program, fragility - fracture, osteoporosis, prevention, treatment
  • DOI : 10.1684/pnv.2011.0304
  • Page(s) : 437-44
  • Published in: 2011

<p>Despite the high morbidity and mortality rate of osteoporosis, the proportion of patients who receive appropriate diagnosis and treatment remains very low. A specific osteoporosis program increased the percentage of patients receiving diagnosis and/or treatment for osteoporosis. We set up a program to improve diagnosis and treatment of patients with low-trauma fractures or suspicion of osteoporosis.</p><p>Two geriatricians were especially designated for this program. The program included patients admitted to the emergency room, inpatients and outpatients from the orthopedic department or the internal medicine/geriatric department. The assessment was performed over two visits and included an evaluation of risk factors for osteoporosis and falls, a physical examination, a collection of biological parameters, and Dual-energy X-ray absorptiometry. In the second visit the physician prescribed, if appropriate, anti-osteoporotic treatment.</p><p>During a two-year period, 156 patients were included in the program; 85.4 % were women. Hip fracture was the most common fracture, followed by vertebral and arm (respectively 28.6%, 11.5%, and 7.6%). While half the patients had a personal history of low-trauma fractures, only 17% received osteoporosis treatment. Anti-osteoporotic treatments were prescribed for 49% of the patients (p<0.001). It was mainly vitamin D (35%), calcium supplementation (31.2%), and oral bisphosphonate (23.6%). Inclusion in our program increased the number of patients receiving anti-osteoporotic treatment from 17.2 to 49.7%. All fallers received falls - prevention counseling based on written materials and oral information.</p><p>A specific program increases the percentage of patients receiving diagnosis and treatment for osteoporosis for patients with low-trauma fractures or suspicion of osteoporosis. Our next objectives are to develop this program to other health care's professionals.</p>