Are we closing the gaps in the management of osteoporosis following fragility fractures of the femur?

Abstract

Objective The objective of this study was to identify deficiencies in initiating anti-osteoporotic treatment following a fragility femoral fracture. Methods All patients ≥55 years of age treated for a fragility femoral fracture between June 2012 and May 2017 were enrolled. Medications at discharge and at 90 days and 1 year of follow up were analyzed. Patients were classified into 4 groups: Group I did not receive any treatment for osteoporosis; Group II received only calcium and vitamin D3; Group III received an anabolic agent, calcium, and vitamin D3; and Group IV received bisphosphonates, calcium, and vitamin D3. Results A total of 167 patients with an average age of 65.81±12.55 years were included. There were 88 (52.7%) males and 79 (47.3%) females. At discharge, 107 patients (64.1%) were not prescribed optimal treatment for osteoporosis, and this reduced to 55 (32.9%) at the 90-day follow up. At 1 year, the number of patients receiving suboptimal treatment was further reduced to 25.74%. Conclusions Although the number of patients with fragility fractures receiving insufficient treatment was lower in the present study than in previous reports, increased efforts and coordinated treatment plans initiated by a fracture liaison service should be of high priority.

Practice of Family Physicians in the Management of Osteoporosis Among Older Female Patients at King Abdulaziz Medical City, Riyadh, Saudi Arabia

“…For example, locally, Sadat‑Ali et al reported even a smaller number of patients who were tested for vitamin D levels [ 8 ]. Similarly, another hospital-based study by Sadat-Ali et al reported that only 42.5% of patients were prescribed vitamin D and calcium, and only 9.6% were given bisphosphonate treatment at discharge after management for femur fragility fractures [ 4 ].…”

“…Osteoporosis is one of the significant global health concerns with 200 million cases reported worldwide [ 2 ]. After heart disease, osteoporosis is considered the most important health issue in developed countries [ 3 ] associated with high rates of morbidity and mortality with marked social and financial impact [ 4 ].…”

“…It was also found that about 60.8% of patients did not receive any treatment for osteoporosis [ 10 ]. A more recent local study reported that among patients with fragility fractures, 64.1% had not received appropriate treatment at the time of discharge and after three months of follow-up, this rate was reduced to 32.9%, which also decreased further after one year to 25.74% [ 4 ].…”