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Male and Non-English-Speaking Patients with Fracture Have Poorer Knowledge of Osteoporosis
Ruth K. Wilson, MD1; George Tomlinson, MSc, PhD2; Venessa Stas, MD3; Rowena Ridout, MD, FRCPC4; Nizar Mahomed, MD, FRCSC, MPH, ScD4; Allan Gross, MD5; Angela M. Cheung, MD, PhD, FRCPC, CCD1
1 University Health Network/Mount Sinai Hospital Osteoporosis Program, 200 Elizabeth Street, 7 Eaton North–221, Toronto, ON M5G 2C4, Canada. E-mail address for A.M. Cheung: Angela.Cheung@uhn.on.ca
2 Toronto General Hospital, 200 Elizabeth Street, Eaton North Wing 13th Floor Room 13EN238, Toronto, ON M5G 2C4, Canada
3 Department of Orthopaedic Surgery, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612
4 Toronto Western Hospital, 399 Bathurst Street, West Wing Room 1-410 (R.R.) and East Wing Room 1-435 (N.M.), Toronto, ON M5T 2S8, Canada
5 Department of Orthopaedics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at University Health Network and Mount Sinai Hospital, Toronto, Ontario, Canada
A commentary by Kimberly J. Templeton, MD, is available at www.jbjs.org/commentary and is linked to the online version of this article.

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Apr 20;93(8):766-774. doi: 10.2106/JBJS.J.00456
A commentary by Kimberly J. Templeton, MD, is available here
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Prior fracture is a strong independent risk factor for subsequent fracture. To date, few studies have examined the level of osteoporosis knowledge specifically in the population of patients who have sustained a fracture. This study was designed to assess the knowledge of osteoporosis among patients who sustained a fracture and who were forty years of age or older, as well as to identify what social factors and health and fracture characteristics determine the level of osteoporosis knowledge in this population.


Patients who had sustained a fracture and were attending fracture clinics at two Toronto hospitals were identified and invited to fill out a questionnaire during their visit. This questionnaire included questions that could be answered by checking "true," "false," or "don't know" and that were designed to assess the patient's knowledge of osteoporosis. The questionnaire also included questions about the respondent's background.


Of 259 patients identified as eligible for the study, 204 (78.8%) agreed to participate. The mean number of correct responses was 16.5 (55%) out of thirty responses. Variables significantly associated with greater numbers of correct responses were female sex, English as a first language, being currently employed, exercising regularly, and having received information from a health-care provider or from a newspaper or magazine.


The level of osteoporosis knowledge was fairly low among the surveyed patients, indicating that more education is needed. This study also highlighted certain characteristics (i.e., male sex, English as a second language, being unemployed, and not exercising) that are associated with a lower level of knowledge. Our results can help target certain groups for osteoporosis educational initiatives, especially ethnic groups whose first language is not English, so as to appropriately reduce the risk of future fractures in this high-risk population.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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