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05-12-2010 | Bone health | Article

Multifaceted wrist fracture intervention saves money, cuts recurrence

Abstract

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MedWire News: A multifaceted intervention for wrist fracture, involving patient education and counseling and physician guidance, is a cost-effective method of improving treatment outcomes, researchers report.

The team, led by Professor Sumit Majumdar at the University of Alberta in Canada, previously demonstrated in a randomized trial that the multifaceted intervention tripled rates of osteoporosis treatment in older patients with wrist fracture within 6 months, compared with usual care. Their latest findings now show that the intervention is cost-effective.

The researchers say: "Healthcare systems implementing similar interventions should expect to save money, reduce fractures, and gain quality-adjusted life expectancy."

Osteoporosis is a common, costly condition, and without evidence-based preventive strategies the incidence and cost of wrist fractures could rise by 50% over the next 2 decades, the researchers warn in the journal Osteoporosis International.

Majumdar et al conducted an economic analysis of their earlier trial of multifaceted intervention to improve treatment for wrist fracture, involving educating and counseling patients with fragility fracture of the wrist, and giving reminders and opinion leader-based treatment guidelines to their primary care physicians.

They followed-up the 272 patients involved in the randomized trial up to 1 year, and used a Markov decision-analytic model to determine the cost-effectiveness of the intervention, compared with usual care, over the patients' remaining lifetime.

The median age of the patients was 60 years, 77% were female, and 72% had low bone mineral density (BMD).

Analysis showed that, for every 100 patients who received the intervention, three fractures, including one hip fracture, would be prevented, and 1.1 quality-adjusted life years gained, with Canadian $26,800 (€20,000) saved over their remaining lifetimes.

The researchers comment: "Compared with usual care, we found that a multifaceted osteoporosis intervention was pragmatic, inexpensive, and highly effective at improving the quality of care for older patients with fractures of the wrist."

They conclude: "On a population-wide basis, healthcare systems that implement interventions similar to ours should anticipate saving money, reducing fractures, and gaining quality-adjusted life expectancy."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Cher Thornhill

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