MedWire News: Few elderly people with hip fracture receive adequate evaluation and treatment for osteoporosis, a study of patients attending US Department of Veterans Affairs (VA) hospitals shows.
Existing guidelines recommend that all patients with low-impact hip fractures undergo treatment for osteoporosis yet studies indicate that less than 20% patients are actually prescribed therapy, note Amal Shibli-Rahhal (University of Iowa Carver College of Medicine, Iowa City) and colleagues.
In the present study, Shibli-Rahhal and team evaluated the level of bone mineral density (BMD) testing and osteoporosis treatment following hip fracture in an integrated US healthcare delivery system - The Veterans Administration Healthcare System.
They reviewed the medical records of 3347 patients treated for hip fracture between 2004 and 2006. The patients had a mean age of 79 years, 96.5% were male, and 83.3% were White.
The team found that only 42 (1.2%) fracture patients underwent BMD testing and only 487 (14.5%) received osteoporosis therapy within 12 months of fracture. The presence of mild versus severe comorbidities did not significantly affect BMD testing and treatment rates.
Logistic regression analysis showed that women were 3.3 times more likely to receive treatment than men, whereas Black people were less likely to be treated than White people (odds ratio=0.67).
"While measurement of bone mineral density is not always necessary to make a diagnosis of osteoporosis after a low-trauma fracture, pharmacotherapy is recommended in most patients with hip fracture, yet our study shows that few veterans received osteoporosis therapy," remark Shibli-Rahhal and co-authors.
They suggest that the VA has been slower than other groups in embracing osteoporosis diagnosis and treatment of osteoporosis because they have focused on quality improvement efforts on diseases that are most common among men (eg, hypertension, heart disease, and lung cancer).
Even so, "these results suggest a substantial opportunity for improvement in the management of fragility fractures in the VA," the researchers conclude in the journal Osteoporosis International.
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