TY - JOUR T1 - A Postfracture Initiative to Improve Osteoporosis Management in a Community Hospital in Ontario AU - Sale, Joanna E.M. AU - Beaton, Dorcas E. AU - Elliot-Gibson, Victoria I.M. AU - Bogoch, Earl R. AU - Ingram, Jennifer Y1 - 2010/08/18 N1 - 10.2106/JBJS.I.00878 JO - The Journal of Bone & Joint Surgery SP - 1973 EP - 1980 VL - 92 IS - 10 N2 - 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. SN - 0021-9355 M3 - doi: 10.2106/JBJS.I.00878 UR - http://dx.doi.org/10.2106/JBJS.I.00878 ER -