Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis

Ganda, Kirtan; Puech, Mme Suzette; Chen, J. S.; Speerin, Robyn; Bleasel, Jane; Eisman, John A.; March, Lyn; Seibel, Markus J.

doi:10.1007/s00198-012-2090-y

Cited by 336 publications

(290 citation statements)

References 70 publications

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“…However, recent literature data suggest that the implementation of multidisciplinary integrated models of care for patients with fragility fracture (e.g. Fracture Liason Service) may optimize the identification of patients at highest risk and make possible an adequate pharmacological treatment in a larger number of patients [22,23]. Moreover, a recent study by Giannini et al [24] carried out in the Veneto region of Italy suggested that a more comprehensive approach to osteoporosis management might reduce hip fracture incidence in people aged 65 years or over.…”

Section: Discussionmentioning

confidence: 99%

Prescription of anti-osteoporosis medications after hospitalization for hip fracture: a multicentre Italian survey

et al. 2016

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Purpose Literature data indicate that the proportion of patients with recent hip fracture who receive a prescription for anti-osteoporotic drugs is low and does not seem to increase over time. This study aimed to obtain data on the prescription for anti-osteoporotic drugs in Italian patients discharged after a recent hip fracture and to assess which variables could have influenced the decision for prescribing osteoporosis medication. Methods A total of four Italian centres located in four different geographical areas (Siena, Verona, Naples and Palermo) participated in this retrospective study. In each centre, experienced clinicians gathered the data of up to 200 consecutive patients discharged after a recent low-trauma hip fracture. The analysis was carried out on 697 patients (540 women and 157 men; mean age 81.9 ± 8.6 years). Results The percentage of patients who were receiving any type of treatment for osteoporosis before the hip fracture was 8.8% (ranging from 2.4% in Naples to 17.4% in Verona). After the index hip fracture, only 23.2% of patients (namely 10.5% of men and 27.2% of women) received prescription for any pharmacological treatments for osteoporosis. Both female gender and previous use of medications for osteoporosis were positively associated with the likelihood of receiving prescription for anti-osteoporotic treatment at discharge. Conclusions This study showed that less than 25% of the elderly Italian patients discharged after a hip fracture received a prescription for any type of treatment for osteoporosis and highlights the urgent need for implementing new strategies in the management of hip fracture patients.

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Section: Discussionmentioning

confidence: 99%

Prescription of anti-osteoporosis medications after hospitalization for hip fracture: a multicentre Italian survey

et al. 2016

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“…(6) This is reflected in many clinical guidelines from around the world that recommend the use of bisphosphonate for patients having sustained a minimal trauma fracture. (7) In January 2005, the National Institute for Health and Care Excellence (NICE) in England and Wales published new guidance recommending bisphosphonate use as a first-line therapy for the secondary prevention of osteoporotic fracture. (8) Moreover, the first-time UK market authorization of generic bisphosphonate alendronic acid occurred in August 2005, after which the cost of therapy fell substantially.…”

Section: Introductionmentioning

confidence: 99%

Anti-Osteoporosis Medication Prescriptions and Incidence of Subsequent Fracture Among Primary Hip Fracture Patients in England and Wales: An Interrupted Time-Series Analysis

Hawley

Leal

Delmestri

et al. 2016

Journal of Bone and Mineral Research

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In January 2005, the National Institute for Health and Care Excellence (NICE) in England and Wales provided new guidance on the use of antiosteoporosis therapies for the secondary prevention of osteoporotic fractures. This was shortly followed in the same year by market authorization of a generic form of alendronic acid within the UK. We here set out to estimate the actual practice impact of these events among hip fracture patients in terms of antiosteoporosis medication prescribing and subsequent fracture incidence using primary care data (Clinical Practice Research Datalink) from 1999 to 2013. Changes in level and trend of prescribing and subsequent fracture following publication of NICE guidance and availability of generic alendronic acid were estimated using an interrupted time series analysis. Both events were considered in combination within a 1-year "intervention period." We identified 10,873 primary hip fracture patients between April 1999 and Sept 2012. Taking into account prior trend, the intervention period was associated with an immediate absolute increase of 14.9% (95% CI, 10.9 to 18.9) for incident antiosteoporosis prescriptions and a significant and clinically important reduction in subsequent major and subsequent hip fracture: -0.19% (95% CI, -0.28 to -0.09) and -0.17% (95% CI, -0.26 to -0.09) per 6 months, respectively. This equated to an approximate 14% (major) and 22% (hip) reduction at 3 years postintervention relative to expected values based solely on preintervention level and trend. We conclude that among hip fracture patients, publication of NICE guidance and availability of generic alendronic acid was temporally associated with increased prescribing and a significant decline in subsequent fractures.

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“…However, variation in FLS service design and reporting of processes and outcomes make comparisons between services difficult. In order to establish which specific features of an FLS are associated with optimal case-finding and implementation of osteoporosis treatment guidelines, Australian investigators undertook a systematic review and meta-analysis of the secondary fracture prevention literature [33]. The various FLS were classified into four types:…”

Section: Secondary Fracture Preventionmentioning

confidence: 99%

“…A systematic approach to fragility fracture care and prevention for New Zealand [66,67] Reproduced with kind permission of Osteoporosis New Zealand Fracture Liaison Service models of care of varying intensity and outcomes [33] van der Kruijs et al [84] Aromatase inhibitors The annual rate of bone loss in women taking AIs is approx. 2.5% as compared to 1-2% for healthy postmenopausal women [85].…”

Section: Mini-abstractmentioning

confidence: 99%

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

et al. 2017

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-none for this submission. EVM -none for this submission. JAK and PJM have undertaken consultancy for governments, national osteoporosis societies, healthcare professional organisations and private sector companies relating to systematic approaches to fragility fracture care and prevention. JYR has no disclosures related to this work, and has received consultancy, lecture fees and grant support from Amgen, Analis, Asahi Kasei, Boehringer, Bristol Myers Squibb, Chiltern, Danone, Ebewee Pharma, Endocyte, Galapagos, GlaxoSmithKline, IBSAGenevrier, Lilly, Merck Sharp and Dohme, Merckle, Negma, Novartis, NovoNordisk, NPS, Nycomed-Takeda, Organon, Pfizer, PharmEvo, Radius Health, Roche, Rottapharm, Servier, Teijin, Teva, Theramex, Therabel, UCB, Will Pharma, Wyeth, Zodiac. NCWH has no disclosures related to this work, and has received consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, Shire, Consilient Healthcare and Internis Pharma. PJM serves as a consultant to the International Osteoporosis Foundation and received remuneration for his contribution to this manuscript. RR has received honoraria for participation in Advisory boards or speaker bureau fees from Danone, Labatec, Nestlé, and ObsEva. Introduction-This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into 4 distinct themes: Europe PMC Funders Group

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Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis

Cited by 336 publications

References 70 publications

Prescription of anti-osteoporosis medications after hospitalization for hip fracture: a multicentre Italian survey

Prescription of anti-osteoporosis medications after hospitalization for hip fracture: a multicentre Italian survey

Anti-Osteoporosis Medication Prescriptions and Incidence of Subsequent Fracture Among Primary Hip Fracture Patients in England and Wales: An Interrupted Time-Series Analysis

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

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