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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/4073

Title: Secondary fracture prevention measures in orthopedic wards in Belgium
Authors: Devogelaer, J. P.
Boutsen, Y.
Declercq, L.
Poriau, S.
Goemaere, S.
Issue Date: 2007
Abstract: Objective: In-hospital diagnosis of osteoporosis in fracture patients in the orthopedic wards is lower than 10% and the prescription rate of treatments is less than 5%. The present report decribes the efficiency of a secondary prevention program in Fracture patients in Orthopedic Wards (FORWARD) in a Belgian hospital care setting. Materials and methods: Orthopedic surgeons willing to participate in the program were requested to refer their patients with clinical fractures for bone densitometry and an osteoporosis specialist's advice. Results: In 36 hospitals data were collected about 4.116 fracture patients. Females represented 73.5% of the population. fracture prevalence increased until the age of 80-85 years, with mean age of 78 year in women and 74 year in men. Most of the fracture cases were hospitalized (88%) and the main fracture type included in the program was hip fracture (45%). Previous clinical fractures were reported in 21% of the patients. Nine percent had previous DXA examination of concomitant osteoporosis treatments and were therefore excluded from DXA referral. Appointments for DXA examination were made in 66% (n=2,718) of the patients and results were obtained from 53% (n=2,181). The diagnostic classification was as follows: osteoporosis 56%, osteopenia 33% and normal bone density 11%. Nearly all cases were referred for diagnostic confirmation of the problem by an osteoporosis specialist, mainly rheumatologists and physiotherapists. Final clinical diagnosis of osteoporosis was accepted in 39% of the cases. Treatment with calcium and vitamin D was started in 1,303 patients (31%), with bisphosphonates in 888 patients (21%) and with SERMs or other drugs in 108 patients (<3%). No data about compliance to these treatments were obtained in the present project. Conclusion: The active referral by orthopedic surgeons of the fracture patients in the orthopedic ward to DXA units and osteoporosis specialists results in the identification of osteoporosis in 39% of the patients. Implementing effective measures and treatments for (secondary) fracture prevention in this high risk population could lead to cost-savings in the short term. Initiatives to promote the patient flow needs to b elaborated and maintained by an active local care organisation.
Notes: Ghent Univ Hosp, Unit Osteoporosis & Metab Bone Dis, Ghent, Belgium. Catholic Univ Louvain, Univ Hosp Mont Godinne, Dept Rheumatol, Yvoir, Belgium. St Augustinus Ziekenhuis, Dept Rheumatol, Antwerp, Belgium. St Elizabeth Hosp, Dept Rheumatol, Sijsele, Belgium. Univ Hasselt, BIOMED, Hasselt, Belgium. Univ Hosp, Dept Rheumatol, Maastricht, Netherlands. Catholic Univ Louvain, Dept Rheumatol, B-3000 Louvain, Belgium.
URI: http://hdl.handle.net/1942/4073
DOI: 10.1007/s00198-007-0333-0
ISI #: 000245980900174
ISSN: 0937-941X
Category: M
Type: Journal Contribution
Appears in Collections: Research publications

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