Hospitals miss osteoporosis treatment opportunities
MedWire News: Study findings published in the Journal of the American Geriatric Society highlight missed opportunities to treat osteoporosis in patients hospitalized for osteoporotic hip fractures.
The researchers found that a tiny fraction of in-patients in a sample of US hospitals received guideline-recommended treatment for osteoporosis, consisting of calcium and vitamin D supplements and an antiresorptive or bone-forming medication.
“Despite proven therapies for osteoporosis, patients with hip fracture remain grossly undertreated, placing them at higher risk for future fractures and resultant morbidity and mortality,” warn Lee Jennings (San Francisco VA Medical Centre, California) and co-authors.
“Future research should focus on identifying barriers and testing interventions to improve rates of in-hospital initiation of guideline-recommended osteoporosis treatment for this vulnerable population.”
Following the success of in-hospital schemes to initiate heart disease medications in at-risk patients, the team investigated the opportunity for osteoporosis treatment in hip fracture patients.
They examined medical records for in-hospital administration of calcium and vitamin D supplements, and antiresorptive or bone-forming medications in 51,346 patients admitted to 318 hospitals for osteoporotic hip fracture.
Just 6.6% of patients were given calcium and vitamin D after treatment, and 7.3% were given anti-osteoporotic drugs. Furthermore, only 2.0% of patients received the ideal therapy of combined calcium and vitamin D supplements, plus osteoporosis treatments.
Jennings et al note that treatment rates were low regardless of patient, healthcare provider, and hospital characteristics.
Although patients were most likely to receive supplements if they were given antiresorptive or bone-forming medications (odds ratio [OR]=5.5), just 27.2% of patients given such drugs received calcium and vitamin D.
Men and Black patients were less likely to receive supplements than women and patients of other races, with ORs of 0.58 and 0.66, respectively.
“Consistent with prior studies, the current study found that treatment rates were lower in patient groups at lower baseline risk for osteoporosis, such as men and African Americans, highlighting the importance of educating patients and providers that fragility hip fractures should prompt treatment in all patients,” the researchers conclude. MedWire/Amgen – bone health
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By Lynda Williams