II Consenso Colombiano para el Manejo de la Osteoporosis Posmenopáusica

Orjuela, Adriana Medina; Rosero, Oscar; Plata, Pedro Nel Rueda; Escobar, Fabio Sánchez; Choueka, Monique Chalem; Reyes, Miguel; Román-Gonzaléz, Alejandro; Lozano, Alexandra; Talero, Amanda Páez; Beltz, Camilo Rueda; Barrera, Carlos Alfonso Builes; Niño, Carlos Augusto Pérez; Fernández-Ávila, Daniel G.; Awad, David Vásquez; Devia, Deyanira González; Pabón, Edgar Pinilla; Valdivieso, Eduardo; Mejía, Esdras Martín Vásquez; Grajales, Francisco Iván Vargas; Restrepo, Francisco Linares; Canales, Geraldine Altamar; Uribe, Gustavo Adolfo Molina; Acero, Gustavo Adolfo Pineda; Quintero, Henry Mauricio Arenas; Patiño, Jorge Augusto Vélez; Restrepo, José Fernando Molina; Raad, Juan José Jaller; Gutiérrez, Ricardo Londoño

doi:10.1016/j.rcreu.2018.02.006

Cited by 9 publications

(8 citation statements)

References 165 publications

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“…During the first year of our FLS program, 76% of patients were evaluated for osteoporosis (by metabolic profile and bone densitometry), conversely to the findings of a 2005 report from four Colombian hospitals describing that only 10% of patients with hip fractures were assessed for osteoporosis [ 18 ]. Following the therapeutic recommendations from the II Colombian Consensus for the Treatment of Postmenopausal Osteoporosis [ 5 ], patients with fragility fractures should be treated with denosumab or teriparatide, considering their elevated risk to develop new fractures. In patients having clinical conditions that contraindicate these two medications, zoledronic acid was the option.…”

Section: Discussionmentioning

confidence: 99%

“…Our program protocol followed the guidelines from the II Colombian Consensus for the treatment of postmenopausal osteoporosis [ 5 ], allowing us to standardize the comprehensive treatment of patients with fragility fractures, in terms of diagnosis, complementary testing, pharmacological treatment, secondary prevention, and follow-up.…”

Section: Program Coordinationmentioning

confidence: 99%

“…In Colombia, it was estimated that, in 2012, there were 2,609,858 and 1,423,559 women with osteopenia and osteoporosis, respectively. By 2050, these patients could increase to 3,852,000 and 2,101,000, respectively [ 5 ]. Hence, a multidisciplinary approach that incorporates primary and secondary prevention measures is key to reduce costs and optimize care.…”

Section: Introductionmentioning

confidence: 99%

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Implementation of a Postfracture Care Program in a Private Hospital in Colombia

Sánchez

Segura

Alajmo

et al. 2020

Journal of Osteoporosis

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Purpose. To describe the implementation of a postfracture care program in a private hospital in Colombia, the results achieved after the program’s first year, and the challenges encountered. Methods. A cross-sectional descriptive study of the first year’s outcomes. The program was implemented following best practices described in the “Capture the Fracture” framework. We assessed the management of fractures before the launch of the program. A multidisciplinary group was established to collaborate on the diagnosis and treatment of patients with osteoporotic fractures. A full-time program coordinator was appointed. We analyzed the program’s clinical outcomes and limitations. Results. One-hundred and ninety patients were included in the study, with an average age of 76.7. Hip fracture was the most frequent one (33.6%). After the first year of implementing the program, 39.4% of patients received osteoporosis treatment, with an adherence rate of 73%. The incidence of subsequent falls was 5.8% and 1% for new fractures. Conclusions. The implementation of a program for patients’ care with fragility fractures is challenging for healthcare institutions. The role of a full-time coordinator is critical for the proper operation of such programs.

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Section: Discussionmentioning

confidence: 99%

Section: Program Coordinationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implementation of a Postfracture Care Program in a Private Hospital in Colombia

Sánchez

Segura

Alajmo

et al. 2020

Journal of Osteoporosis

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“…Fragility fractures are associated with high disability, loss of independence, reduced quality of life for patients and caregivers, and high costs for health care systems [ 2 , 3 , 5 ]. Despite the associated high rates of morbidity and mortality, osteoporosis continues to be underdiagnosed and undertreated [ 6 ]. Treatment of osteoporosis after a fragility fracture reduces the risk of new fractures [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Characterization and effectiveness of a Fracture Liaison Services program in Colombia

Valladales-Restrepo,

Castro-Osorio,

Ramírez-Osorio

et al. 2023

Arch Osteoporos

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Purpose Fracture Liaison Services programs reduce mortality and the risk of refracture and increase treatment and adherence rates. Greater coverage is an important priority for the future. The aim was to determine the characteristics of patients over 50 years old who suffered fractures and the effectiveness of a Fracture Liaison Services program in a health care institution in Colombia. Methods This was a retrospective follow-up study of a cohort of patients with vertebral and nonvertebral fractures managed in a Fracture Liaison Services program. Sociodemographic, clinical and pharmacological variables were identified. Key performance indicators were used to evaluate the effectiveness of the program. Descriptive and bivariate analysis was performed. Results A total of 438 patients were analyzed. The average age was 77.5 years, and 78.5% were women. Hip and vertebral fractures were the most common (25.3% and 24.9%, respectively). Vertebral fractures prevailed in men (33.0% vs 22.7%; p = 0.041) and those of the radius/ulna in women (20.3% vs 10.6%; p = 0.031). A total of 29.7% had experienced a previous fracture, and 16.7% had received antiosteoporosis drugs. A total of 63.5% of the cases were managed surgically. At discharge, 58.8% received prescriptions for calcium/vitamin D, and 50.7% with prescriptions of antiosteoporotic therapy, especially teriparatide (21.2%) and denosumab (16.4%), without significant differences by sex. However, in women with hip fractures, anti-osteoporotic management prevailed (83.7% vs 64.0; p = 0.032). The effectiveness of the overall program per year was 74.6%. On follow-up, only 9.1% of patients had experienced a new fall, and of those 3.7% presented a new fracture. A total of 4.3% died during follow-up. Conclusions Good adherence to the recommendations of the country's clinical practice guidelines was found, and overall, the effectiveness of the program was very satisfactory, with a low incidence of new fractures during follow-up. Summary Fracture Liaison Services programs reduce mortality and the risk of refracture. A retrospective follow-up study of a cohort of patients with vertebral and nonvertebral fractures managed in a Fracture Liaison Services, showed that the effectiveness was 73.6%. On follow-up, 9.1% of patients had experienced a new fall, and of those 3.7% presented a new fracture.

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“…Sin embargo, debido a recursos económicos limitados, en Colombia pocas veces se practican exámenes diagnósticos previos a la fractura teniendo en cuenta los perfiles de riesgo y hay limitada implementación de tratamientos preventivos. La mayoría de los casos de fragilidad ósea en Colombia se identifican cuando las fracturas ocasionadas son de mayor gravedad que la esperada ante a un accidente o evento desencadenante, o cuando hay fracturas recurrentes (9).…”

Section: Introductionunclassified

Descripción de los factores de riesgo relacionados a las fracturas por fragilidad en adultos y sus costos asociados

Leal-Bello¹,

Maldonado-Martínez²,

Quevedo³

et al. 2022

Acta Med Col

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Objetivo: identificar factores de riesgo de fragilidad ósea asociados al aumento de costos totales de atención de fracturas en una clínica de Medellín, Colombia. Diseño: estudio observacional con medidas retrospectivas y prospectivas tomadas de la historia clínica de pacientes atendidos por fractura y seguidos hasta su egreso. Marco de referencia: Hospital Alma Máter de Antioquia, Medellín, Colombia. Participantes: cuatrocientos cincuenta y dos pacientes diagnosticados con fracturas por fragilidad al ingreso. Mediciones principales: prevalencia de factores de riesgo de fragilidad ósea, descripción de costos totales de atención según factores de riesgo, y estimación de asociaciones entre factores de riesgo y costos totales. Resultados: diabetes (24.3%) y tabaquismo activo o pasivo (21%) fueron los factores de riesgo de fragilidad más prevalentes. Las fracturas de cadera fueron las más frecuentes y costosas (36%, Md: COP7 882 579). La atención de fracturas fue más costosa para pacientes fumadores activos o pasivos (Md: COP7 484 185), y de 75 años o más (Md: COP7 057 678). Según las estimaciones ajustadas significativas (p<0.05), los fumadores activos o pasivos tienen una mediana de costos de más de COP2 300 000 mayor que la de no fumadores, y cada año de edad incrementa la mediana de costos más de COP90 000. Conclusiones: este estudio enfatizó que la fragilidad ósea es un problema de salud pública. Se identificó que factores como fumar activa o pasivamente, y la edad aumenta los costos de atención de fractura por fragilidad implicando mayores complicaciones y necesidad de servicios. Esto añade a la evidencia para fortalecer los programas de vigilancia que reduzcan la morbimortalidad y costos directos de esta enfermedad en Colombia.

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II Consenso Colombiano para el Manejo de la Osteoporosis Posmenopáusica

Cited by 9 publications

References 165 publications

Implementation of a Postfracture Care Program in a Private Hospital in Colombia

Implementation of a Postfracture Care Program in a Private Hospital in Colombia

Characterization and effectiveness of a Fracture Liaison Services program in Colombia

Descripción de los factores de riesgo relacionados a las fracturas por fragilidad en adultos y sus costos asociados

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