The activity of a Spanish bone densitometry unit revisited under the point of view of FRAX

Gómez-Vaquero, Carmen; Bianchi, Martha S.; Santo, Pilar; Roig-Vilaseca, Daniel; Narváez, Javier; Nolla, Joan M.

doi:10.1016/j.reumae.2012.06.014

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…In interventional studies aimed at improving osteoporosis management after a fracture, bone densitometry was used in a median of 43% of patients [7]. However, in Spain, the use of bone densitometry (Dual energy X-ray absorciometry) for fracture risk assessment is limited [8]. Moreover, despite the availability of medications proven to reduce the risk of further fractures [9], fewer than 20% of individuals who sustain a fragility fracture receive such therapies within the first year following the fracture [10,11].…”

Section: Introductionmentioning

confidence: 99%

Best Practice Framework of Fracture Liaison Services in Spain and their coordination with Primary Care

et al. 2020

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The coordination of Fracture Liaison Services (FLS) with Primary Care (PC) is necessary for the continuity of care of patients with fragility fractures. This study proposes a Best Practice Framework (BPF) and performance indicators for the implementation and follow-up of FLS-PC coordination in clinical practice in Spain. Purpose To develop a BPF for the coordination of FLS with PC in Spain and to improve the continuity of care for patients with fragility fractures. Methods A Steering Committee selected experts from seven Spanish FLS and related PC doctors and nurses to participate in a best practice workshop. Selection criteria were an active FLS with an identified champion and prior contact with PC centres linked to the hospital. The main aim of the workshop was to review current FLS practices in Spain and their integration with PC. A BPF document with processes, tools, roles, and metrics was then generated. Results Spanish FLS consists of a multidisciplinary team of physicians/nurses but with low participation of other professionals and PC staff. Evaluation and treatment strategies are widely variable. Four desired standards were agreed upon: (1) Effective channels for FLS-PC communication; (2) minimum contents of an FLS clinical report and its delivery to PC; (3) adherence monitoring 3 months after FLS baseline visit; and (4) follow-up by PC. Proposed key performance indicators are (a) number of FLS-PC communications, including consensus protocols; (b) confirmation FLS report received by PC; (c) medical/nursing PC appointment after FLS report received; and (d) number of training sessions in PC. Conclusions The BPF provides a comprehensive approach for FLS-PC coordination in Spain, to promote the continuity of care in patients with fragility fractures and improve secondary prevention. The implementation of BPF recommendations and performance indicator tracking will benchmark best FLS practices in the future.

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Section: Introductionmentioning

confidence: 99%

Best Practice Framework of Fracture Liaison Services in Spain and their coordination with Primary Care

et al. 2020

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“…Cette observation met en exergue l'influence des facteurs de risque cliniques (FDR) en plus des paramètres densitométriques dans l'estimation du risque fracturaire. Si les données épidémiologiques avaient montré que la diminution de la DMO était le seul facteur de risque pertinent de prédiction des fractures, il est admis actuellement que cette baisse ne permet pas d'expliquer à elle seule toutes les complications fracturaires (16). Les FDR doivent donc être pris en compte pour prédire avec beaucoup plus de finesse le risque fracturaire, et même décider d'une sanction thérapeutique lorsque ledit risque est très important (17).…”

Section: Discussionunclassified

“…Cette quantification du risque fracturaire repose sur le calcul d'un index composite dénommé Fracture Risk Assessment Tool (FRAX), outil proposé par l'Organisation mondiale de la Santé (OMS), qui permet de calculer le risque absolu à 10 ans des fractures ostéoporotiques majeures (11). En République Démocratique du Congo, comme en Afrique Sub-Saharienne, peu de données sont disponibles sur l'évaluation du risque fracturaire dans l'ostéoporose (12)(13)(14)(15)(16). Pourtant, les années à venir il est possible que ce continent connaisse une augmentation des cas, à cause notamment de l'amélioration de l'espérance de vie, d'une tendance croissante à la sédentarité, etc.…”

Section: Introductionunclassified

Ostéoporose et évaluation du risque fracturaire par l’outil frax chez des patients Congolais présentant un rhumatisme axial : Une série des cas multicentriques

Mavinga¹,

Mbuyi²,

Matanda³

et al. 2022

Ann. Afr. Med

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Contexte et objectif. L’enjeu majeur dans le management de l’ostéoporose est l’identification des sujets à risque par la quantification du risque fracturaire. L’objectif de l’étude était d’évaluer le risque fracturaire chez les patients ayant consulté pour douleur du squelette axial. Méthodes. Il s’agissait d’une série des cas multicentriques menée sur des patients recrutés dans 8 hôpitaux de Kinshasa. Les paramètres d’intérêt comme l’âge, le sexe, l’alcoolisme, le tabagisme, la fracture de hanche chez un parent de 1er degré ou une fracture personnelle de fragilité ont été collectés auprès de chaque patient. La mesure de la densité osseuse avait été réalisée par absorptiométrie biphotonique à rayons X. Le risqué fracturaire a été évalué par le calcul de l’indice fracturaire FRAX. Ce risque était élevé lorsque la probabilité de survenue de fracture de hanche était ≥ 3% et/ou des fractures ostéoporotiques majeures ≥ 20%. Des tests statistiques usuels ont été utilisés pour l’analyse des résultats. Résultats. 90 patients dont 75 femmes étaient inclus. Leur âge moyen était de 63,5±12 ans. L’ostéoporose était diagnostiquée chez 34,4% des patients, l’ostéopénie chez 43,9% et 16,7% avaient une densité minérale osseuse normale. Aucune fracture ostéoporotique n’a été observée dans la présente étude, mais près de 30% de l’ensemble de l’échantillon avaient un risque fracturaire élevé. L’ostéoporose était associée, dans environ 80% des cas (p<0,005), à un risqué fracturaire élevé. Conclusion. La présente étude a montré que le risque fracturaire était élevé chez les patients atteints d’ostéoporose. Elle met en lumière la nécessité d’un dépistage précoce de cette pathologie. English title: Osteoporosis and assessment of fracturary risk using the frax tool in Congolese patients with axial rheumatism: A multicenter case series Context and objective. The major challenge in the management of osteoporosis is the identification of subjects at risk by quantifying the fracture risk in order to prevent the fracture cascade. The aim of the present study was to evaluate the fracture risk in patients who had consulted for axial skeletal pain. Methods. This was a multicenter case series carried out on patients with axial rheumatism recruited in 8 hospitals in Kinshasa. The parameters of interest such as age, sex, alcoholism, smoking, hip fracture in a 1st degree relative or personal fragility fracture were collected from each patient. Bone mineral density was measured by dual energy x-ray absorptiometry. Fracture risk was assessed by calculating the FRAX fracture index. This risk was considered high when the probability of occurrence of a hip fracture was ≥ 3% and/or major osteoporotic fractures ≥ 20%. Standard statistical tests were used to analyze the results. Results. 90 patients including 75 women (83.3%) were involved. Their average age was 63.5±12 years. Osteoporosis was diagnosed in 34.4% of patients, osteopenia in 43.9% of patients and 16.7% of patients had normal bone mineral density. No osteoporotic fractures were observed, but nearly 30% of the entire sample had a high fracture risk. Osteoporosis (T-score ≤-2.5) was associated, in approximately 80% of cases (p<0.005), with a high fracture risk. Conclusion. The present study showed that fracture risk was very high in patients with osteoporosis. It highlights the need for early detection of this pathology. Keywords: Osteoporosis, axial rheumatism, fracturary risk, FRAX

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“…Studies from Turkey, United States and Canada found that FRAX® scores calculated with and without BMD were comparable. 5–8 In contrast, a study from Spain showed lower fracture risks with inclusion of BMD, 9 whereas studies from United Kingdom and South Korea reported that inclusion of BMD resulted in increased number of participants eligible for medication and a general increase in FRAX® scores, respectively. 10,11 These differences may be due to variation of BMD in different regions.…”

Section: Introductionmentioning

confidence: 96%

Influence of bone mineral density measurement on fracture risk assessment tool® scores in postmenopausal Indian women

et al. 2016

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The activity of a Spanish bone densitometry unit revisited under the point of view of FRAX

Cited by 4 publications

References 17 publications

Best Practice Framework of Fracture Liaison Services in Spain and their coordination with Primary Care

Best Practice Framework of Fracture Liaison Services in Spain and their coordination with Primary Care

Ostéoporose et évaluation du risque fracturaire par l’outil frax chez des patients Congolais présentant un rhumatisme axial : Une série des cas multicentriques

Influence of bone mineral density measurement on fracture risk assessment tool® scores in postmenopausal Indian women

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