Factors predictive of the perceived osteoporosis–fracture link in fragility fracture patients

Abstract

ObjectiveGiven the asymptomatic nature of osteoporosis, a fragility fracture provides an opportunity to make the issue of osteoporosis relevant to patients. Patients who link their fragility fracture with osteoporosis are more likely to initiate osteoporosis treatment, yet to date, we know little about who is likely to make this link. This study examined whether demographic, health, and osteoporosis belief factors predicted a perceived link between a fragility fracture and osteoporosis. Study designThis longitudinal cohort study analyzed baseline and follow up data collected as part of a provincial osteoporosis screening initiative targeting fragility fracture patients. Logistic regression analysis was used to examine the relationship between hypothesized predictors and the outcome. Main outcome measurePatient perception of the osteoporosis–fracture link at follow up. ResultsAt baseline, 93% (1615/1735) of patients did not believe their fracture could have been caused by osteoporosis. Of these, only 8.2% changed this perception at follow up. Adjusted analyses showed that baseline characteristics associated with making the osteoporosis–fracture link at follow up were: a previous fracture (odds ratio (OR) 1.7, confidence interval (CI) 1.2–2.6), perception of osteoporosis pharmacotherapy benefits OR 1.2 (CI 1.0–1.5), diagnosis of rheumatoid arthritis OR 2.6 (CI 1.4–4.9) and the perception of bones as “thin” OR 8.2 (CI 5.1–13.1). ConclusionThese results shed more light on patient-level barriers to osteoporosis management following an osteoporosis educational programme. They may be used to identify patients less likely to make the link between their fracture and osteoporosis and to inform interventions for this patient group.