General physician’s and primary care nurse’s contribution to the osteoporotic hip fracture identification in the Republic of Uzbekistan

Abstract

Precise population-based data on the osteoporotic hip fracture (HF) rate play an invaluable role in the assessment of burden of osteoporosis as well as in development of the national clinical fracture risk prediction tool (FRAX). Currently, these data in Uzbekistan is unavailable. Aim. To create a system for the all HF detection to calculate their incidence in Uzbekistan, and to assess the general physicians (GP) and primary care nurses role in this system.
 Materials and methods. Cohort study was carried out in 20112017 in the Pap district of Uzbekistan We had revealed the national trauma care records peculiarities and then organized the prospective study. The trauma care records were monitored. Besides, all medical specialists including GPs, GP nurses and the community leaders were actively involved into the search and verification of non-hospitalized hip fracture patients escaping trauma care statistics.
 Results. Overall, among HF patients, only 34% were hospitalized, and 26% took outpatient trauma care. Additional 29% of HF patients were found only with the help of GPs. GP nurses in collaboration with the community leaders disclosed additional 11% patients who had been staying at home without any medical care. The annual standardized HF incidence in people older than 40 years enriched 357.7 for women and 190.2 for men per 100 000.
 Conclusion. Collection of epidemiological information on HF incidence in Uzbekistan was possible only with the help of GPs and GP nurses as key figures of primary care. The obtained epidemiological data will be incorporated into the first created Uzbek national FRAX model to assess the 10-year risk of osteoporotic fracture in clinical practice.