RT Journal
A1 Sale, Joanna E.M.
A1 Beaton, Dorcas E.
A1 Elliot-Gibson, Victoria I.M.
A1 Bogoch, Earl R.
A1 Ingram, Jennifer
T1 A Postfracture Initiative to Improve Osteoporosis Management in a Community Hospital in Ontario
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2010
FD August 18
VO 92
IS 10
SP 1973
OP 1980
DO 10.2106/JBJS.I.00878
UL http://dx.doi.org/10.2106/JBJS.I.00878
AB 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.