Treatment of osteoporosis in postmenopausal hip fracture patients after geriatric rehabilitation

Gosch, M.; Roth, Tobias; Kammerlander, Christian; Joosten-Gstrein, B.; Benvenuti-Falger, Ursula; Blauth, M.; Lechleitner, Monika

doi:10.1007/s00391-011-0254-6

Cited by 21 publications

(4 citation statements)

References 26 publications

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“…In einem entsprechenden interdisziplinären Setting kann die Therapierate nach Fraktur mit einer antiresorptiven oder osteoanabolen Substanz von 14,7 auf 43 % signifikant erhöht werden [11]. Eine Basismedikation mit Kalzium und Vitamin D3 erhielten knapp 90 % aller Patienten mit einer Fragilitätsfraktur [11], dabei beträgt die empfohlene Kalziumeinnahme 1000 mg/Tag, welche idealerweise über die Nahrung durch Milchprodukte aufgenommen werden sollte, sowie eine Vitamin-D-Supplementierung von 800-1000 IE/Tag, welche häufig durch eine vorübergehend höher dosierte Loadingdosis ersetzt werden muss.…”

Section: Therapieunclassified

Augmentationstechnik am proximalen Femur

Neuerburg

Gosch

Blauth³

et al. 2015

Unfallchirurg

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In addition to the optimal surgical treatment, secondary prevention such as osteoporosis management to avoid further fractures is crucial in the treatment of these patients. This article is based on the current literature and provides an overview of the possible applications of cement augmentation for the treatment of proximal femoral fractures. In addition the surgical approach as well as previous scientific data on an established osteosynthesis using cement-augmented PFNA for the treatment of pertrochanteric frailty fractures are presented.

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Section: Therapieunclassified

Augmentationstechnik am proximalen Femur

Neuerburg

Gosch

Blauth³

et al. 2015

Unfallchirurg

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“…A population-based cohort study showed that orthogeriatric co-management was associated with significantly increased prescription of osteoporosis medication at discharge [ 24 ]. Four other studies have reported an improved coverage of osteoporosis medication after orthogeriatric care implementation, rising from 30.9 to 54.6% [ 25 ], 11.8 to 68.9% [ 26 ], 1 to 54% [ 27 ], and 39.6 to 65.5% [ 28 ]. Similarly in this study, coverage rate for early anti-osteoporosis agent prescription significantly improved from 25.1% in the conventional group to 58.1% in the protocol group ( p < 0.001) Also, the coverage for early BMD assessment significantly improved from 52.4 to 94.8% through our protocol.…”

Section: Discussionmentioning

confidence: 99%

Improved outcomes and reduced medical costs through multidisciplinary co-management protocol for geriatric proximal femur fractures: a one-year retrospective study

Tung

Cho

et al. 2022

BMC Geriatr

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Background To manage the rapidly growing incidence of, and related medical burden resulting from hip fractures in older adults in an aging society, studies involving orthogeriatric co-management treatment models have reported improved outcomes, including reduced medical costs. The treatment gap for osteoporosis was however seldom emphasized in the published treatment protocols. Aiming to improve the existing orthogeriatric protocol, we have established a patient-centered protocol for elderly patient hip fractures, which simultaneously focuses on fracture care and anti-osteoporosis agent prescription in regarding to healthcare quality and medical expense. Methods This was a retrospective study comparing patients who enrolled in the multidisciplinary co-managed protocol for geriatric hip fractures and those who did not. The inclusion criteria for this study were: (a) single-sided hip fractures treated from 1 to 2018 to 30 June 2020, (b) patients who were 60-years or older (c) trauma treated within 3 days from time of injury, and (d) minimal follow-up period of 12 months after surgery. Results From 1 to 2018 to 30 June 2020, 578 patients were included (267 patients in the protocol group vs. 331 patients in the conventional group). The protocol group was associated with significantly reduced lengths of hospital stay (p = 0.041), medical expenditures (p = 0.006), and mortality (p = 0.029) during their acute in-hospital admission period. Early osteoporosis diagnosis and anti-osteoporosis agent prescription were achieved in the protocol group, with a significantly wider coverage for BMD assessment (p < 0.001) and prescriptions for anti-osteoporosis medication (p < 0.001). Yet, there was no significant decline in the one-year refracture rate in the protocol group. Conclusions The implementation of a multidisciplinary co-managed care protocol for geriatric proximal femur fractures successfully improved patient outcomes with significantly reduced lengths of stay, medical expenditures, and mortality during the acute in-hospital admission period. The high prescription rate of anti-osteoporosis medication after hip fractures in the protocol group was not associated with a significantly lower re-fracture rate in the 12-month follow-up. However, the association between early anti-osteoporosis agent prescription and reduced long-term medical expenses in this group of patients has provided a direction for future research.

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“…Zu nennen sind insbesondere der "Fracture liason service" oder das interdisziplinäre Management durch "Osteoporosis care manager". Rezent wurden auch Projekte zu diesem Thema in Österreich durchgeführt und deren Ergebnisse publiziert [14][15][16][17]. Im Rahmen dieser Co-Management-Programme ergeben sich signifikant höhere Behandlungsraten.…”

Section: Defizite Im Nahtstellenmanagementosteoporosis Care Gapunclassified

“…Im Rahmen dieser Co-Management-Programme ergeben sich signifikant höhere Behandlungsraten. So erhielten zum Beispiel im Tiroler Zentrum für Altersfrakturen immerhin 43 % aller Patienten nach einer Hüftfraktur eine spezifische Osteoporosetherapie [17].…”

Section: Defizite Im Nahtstellenmanagementosteoporosis Care Gapunclassified

Osteoporose – Therapie und sektorenübergreifendes Management

Mikosch

Gosch

2013

Wien Med Wochenschr

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Osteoporosis is defined as a systemic bone disorder with decreased bone strength and an increased susceptibility for fragility fractures. In particular elderly people face an increased fracture risk. Fracture stabilisation by different methods of osteosynthesis and fast remobilisation has become standard procedures after a fragility fracture due to osteoporosis. However, only a small group of patients receive osteoporosis drug therapy with the aim to reduce the rate of further fractures. In literature this has been described as "osteoporosis care gap". In the past, various projects have been performed in order to overcome this problem of osteoporosis care after fragility fractures. The article presents the current problems in daily routine concerning the initiation of an osteoporosis therapy after a fracture. A simple concept of necessary procedures and questions is presented as a possible solution for the interface management of osteoporosis drug therapy after fragility fractures. In addition, current osteoporosis therapies are presented in the view of care for geriatric patients.

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Treatment of osteoporosis in postmenopausal hip fracture patients after geriatric rehabilitation

Cited by 21 publications

References 26 publications

Augmentationstechnik am proximalen Femur

Augmentationstechnik am proximalen Femur

Improved outcomes and reduced medical costs through multidisciplinary co-management protocol for geriatric proximal femur fractures: a one-year retrospective study

Osteoporose – Therapie und sektorenübergreifendes Management

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