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A Postfracture Initiative to Improve Osteoporosis Management in a Community Hospital in Ontario

Sale, Joanna E.M. PhD; Beaton, Dorcas E. PhD; Elliot-Gibson, Victoria I.M. MSc; Bogoch, Earl R. MD; Ingram, Jennifer MD

Journal of Bone & Joint Surgery - American Volume: 18 August 2010 - Volume 92 - Issue 10 - p 1973–1980
doi: 10.2106/JBJS.I.00878
Scientific Articles
Supplementary Content

Background: Screening programs to manage osteoporosis in fracture clinic environments have had varying success in terms of increasing rates of investigation and initiation of treatment for the disease.

Methods: We determined rates of postfracture investigation and care for osteoporosis in patients screened through a coordinator-based initiative in a community hospital fracture clinic. A coordinator screened outpatients, educated them about osteoporosis, advised them to see their family physician for assessment and/or treatment, and performed follow-up at six months. Men who were fifty years of age or older and women who were forty years of age or older and had a fragility fracture were eligible.

Results: Of 505 patients enrolled at baseline, 332 (66%) returned the follow-up questionnaire; 51% of those patients reported having had a bone mineral density test after screening and 26% had initiated first-line treatment (35% if the patients who had already initiated treatment at baseline were excluded) and an additional 23% were continuing treatment since baseline. After adjustment for demographic and baseline variables, patients who had initiated first-line treatment after screening were 4.15 times more likely to have had a bone mineral density test after screening than patients who had never initiated treatment and 11.67 times more likely to have had a bone mineral density test after screening than patients who had continued treatment since baseline.

Conclusions: A coordinator-based osteoporosis screening program was associated with osteoporosis investigation and treatment. A postfracture bone mineral density test was highly associated with treatment initiation.

1Mobility Program Clinical Research Unit, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada. E-mail address for J.E.M. Sale: salej@smh.toronto.on.ca

2Peterborough Regional Health Centre, 1 Hospital Drive, Peterborough, ON K9J 7C6, Canada

Copyright 2010 by The Journal of Bone and Joint Surgery, Incorporated
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