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Osteoporos Int. 2007 Dec;18(12):1633-9. Epub 2007 Jun 30.

Successful direct intervention for osteoporosis in patients with minimal trauma fractures.

Author information

1
Bone and Mineral Research Program, Garvan Institute of Medical Research, Sydney, NSW, Australia. ivankuo@optushome.com.au

Abstract

In this study, we offered osteoporosis investigation and treatment directly to patients at out-patient fracture clinics shortly after they sustained minimal trauma fractures. We achieved long-term compliance to the recommended investigation and treatment in 80% of patients. This approach is much more successful than previous interventions.

INTRODUCTION:

Osteoporosis remains under-treated in minimal-trauma fracture subjects. The aim of this study was to determine if direct intervention at orthopaedic fracture clinics would improve post-fracture management in these subjects.

METHODS:

From March 2004 to March 2006, 155 consecutive minimal-trauma fracture subjects (mean age 64.0 +/- 17.6) attending fracture clinics at St. Vincent's Hospital, Sydney, had a specific medical assessment, following which they were recommended BMD and laboratory testing. Treatment recommendations were given after review of investigations with further follow-up at a median of 8.6 months following therapy. Comparison of outcomes was made with a similar group of patients given written information 2 years prior.

RESULTS:

At baseline, 47% of patients had prior fractures, but only 26% had had BMD screening. Twenty-one percent were on anti-resorptive therapy, and 15% were on calcium/vitamin D. Following intervention, 83% had a BMD and of these, 68% had a T-score < -1.0. Of treatment naïve patients, 44% were recommended anti-resorptive therapy and 56% were recommended calcium/vitamin D. Compliance was 80% for anti-resorptive and 76% for calcium/vitamin D. Female gender and lower BMD were predictors of compliance.

CONCLUSION:

Compared with information-based intervention, direct intervention improved management two to fivefold, maintaining long-term treatment in 90% of osteoporotic and 73% of osteopenic subjects requiring therapy.

PMID:
17603741
DOI:
10.1007/s00198-007-0418-9
[Indexed for MEDLINE]

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