Primary and secondary osteoporotic fractures prophylaxis: evaluation of a prospective cohort

Abstract

ObjectiveTo measure the prevalence of primary drug prevention of fractures due to osteoporosis in patients admitted to a tertiary teaching hospital, in a medium-sized city, admitted with osteoporotic fractures. Moreover, to identify the incidence of prescribing secondary prophylaxis after the first fracture event. At the same time, the prevalence of risk factors for such fractures as described in the literature was measured.MethodsThis longitudinal prospective study was based on a cohort of patients admitted in a tertiary teaching hospital from October 2015 to January 2016. Patients with low energy or fragility fractures were included in the study regardless of gender or race, over the age of 50 years. All patients who did not have these characteristics were excluded. The follow-up lasted four months. Serial questionnaires were applied at admission and in the follow-up consultations at four to eight weeks and at 16 weeks.ResultsOnly one patient reported receiving treatment with specific drugs for the disease before hospital admission, resulting in a prevalence of primary chemoprophylaxis of only 2.27%. No patient was prescribed medication for the treatment of osteoporosis after the fracture. The prevalence of risk factors was similar to those found in the literature review.ConclusionIn the present study, the frequency of primary and secondary osteoporosis chemoprophylaxis in patients who were admitted with fragility fractures was low, as well as the early indication of drug treatment after the first fracture. The prevalence of fragility fracture risk factors is similar to those reported in the literature.

Atualização do Tratamento Medicamentoso da Osteoporose

“…The second question is: how to identify who needs to be treated? According to the National Osteoporosis Foundation (NOF), the recommendations for the treatment of osteoporosis in women and men > 50 years old are as follows: [1][2][3][4][5][6] 1. Presence of vertebral or femoral fracture due to frailty (minimal trauma); 2.…”

“…Presence of fragility fracture with other risk factors is clinical diagnosis of osteoporosis regardless of the value in densitometry, with formal indication for treatment. [2][3][4][5][6] Fracture due to mild trauma (fall from one's own height) or bone fragility is already an indication for treatment. Several guidelines indicate treatment in T-Score < -2.4 and presence of risk factors in the absence of fractures.…”

“…Vitamin D, being a hormone, activates intestinal calcium absorption and it is necessary to supplement elderly, sedentary or hospitalized individuals. [3][4][5][6] Calcium carbonate, the most common in capsules, contains 40% calcium, so for 500 mg of the element, one requires 1,250 mg of carbonate, best used when ingested next to a meal. Calcium carbonate can cause intestinal constipation, being reported as a cause of kidney stones.…”

“…Presence of fragility fracture with other risk factors is clinical diagnosis of osteoporosis regardless of the value in densitometry, with formal indication for treatment. 2 3 4 5 6 …”

“…Treating osteoporosis patients, mortality decreases, and this should be our main concern. 1 2 3 4 5 6 …”