Abstract
Aim: To determine the proportion of patients admitted to a major tertiary teaching hospital in Australia aged 50 years and older with a confirmed neck of femur or vertebral minimal trauma fracture, who are commenced on specific antiosteoporosis therapy by discharge, and to describe the agents prescribed. Methods: A retrospective analysis was conducted using patients’ electronic medical files of patients admitted with a minimal trauma fracture of the hip or vertebra during a 6 month period. Results: A total of 407 patients were audited and 64 patients were included in the study; 37 were admitted for a fractured hip and 27 were admitted for a vertebral fracture. Of these 64 patients, a total of 14 (21.9%) patients were commenced on specific anti-osteoporosis therapy. Denosumab (71%) was the most commonly initiated treatment, followed by risedronate (21%) then alendronate (7%). Conclusion: Majority of patients presenting to hospital with a minimal trauma fracture were not commenced on anti-osteoporosis therapy in hospital. This is a missed opportunity for intervention that may place patients at a higher risk of subsequent fracture; therefore effective strategies should be implemented to address this treatment gap in the future.
Highlights
Osteoporosis is a public health concern, both globally and in Australia (AIHW, 2014; Ebeling et al, 2007) with a total of 66% of Australians aged over 50 affected by osteoporosis or osteopenia in 2012 and a cost to Australia of over $2.75 billion per annum (Watts et al, 2013)
Study design This study was a retrospective inpatient file audit performed at a tertiary teaching hospital in Victoria, Australia
Outcome measures The primary outcome was to determine the proportion of patients commenced on specific antiosteoporosis therapy on or before discharge; and to describe the specific agents selected for those starting on specific anti-osteoporosis therapy on or before discharge
Summary
Osteoporosis is a public health concern, both globally and in Australia (AIHW, 2014; Ebeling et al, 2007) with a total of 66% of Australians aged over 50 affected by osteoporosis or osteopenia in 2012 and a cost to Australia of over $2.75 billion per annum (Watts et al, 2013). With the average life-expectancy of the Australian population increasing, the prevalence of osteoporosis and osteopenia is expected to rise and affect approximately 6.2 million people by 2022 (Watts at al., 2013). As there are no noticeable symptoms, osteoporosis is often diagnosed after the first minimal trauma fracture (Panneman et al, 2004). Studies have shown that 40-60% of men and women will experience a subsequent minimal trauma fracture within 10 years of an initial fracture (Center et al, 2007)
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