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Arthritis Rheum. 2007 Dec 15;57(8):1502-6.

Osteoporosis disease management for fragility fracture patients: new understandings based on three years' experience with an osteoporosis care service.

Author information

1
University of Wisconsin School of Medicine and Public Health, Madison, WI 53715, USA. tim.Harrington@uwmf.wisc.edu

Abstract

OBJECTIVE:

To review the 3-year performance of an established osteoporosis care service and consider further improvements in an effort to reduce fragility fractures.

METHODS:

Osteoporosis care has been coordinated for all willing and able patients with orthopedic fragility fractures in our health system by a nurse and medical director since 2003, using a guideline-based care algorithm and task management software. Patients were followed by telephone for 2 years to monitor their status and optimize adherence to treatment. Demographics, management recommendations, clinical data, and adherence to treatment were reviewed for the 2003-2005 patient population.

RESULTS:

Of 1,019 patients with fragility fractures, 61% underwent osteoporosis evaluation and treatment. The remainder included 15% who refused to participate and 24% who were unable to participate for various logistical and health reasons. More patients age >80 years were unwilling or unable to participate. Bone densities (dual x-ray absorptiometry [DXA]) were normal, low, or osteoporotic in 24%, 55%, and 21% of patients, respectively, and 60% of the osteoporotic group had > or = 1 abnormal metabolic bone laboratory result. Only 17% of the total reported a previous fracture, and 47% had ever undergone DXA. Few experienced bone loss, a new fracture, or bisphosphonate intolerance during treatment.

CONCLUSION:

An osteoporosis care service has coordinated care for every willing and able fragility fracture patient with positive outcomes. In addition, the results suggest a high priority for earlier proactive diagnosis and intervention of the at-risk population if fractures are to be reduced.

PMID:
18050169
DOI:
10.1002/art.23093
[Indexed for MEDLINE]
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