An osteoporosis clinical pathway for the medical management of patients with low-trauma fracture

Patients with an osteoporotic fracture have at least a 2-fold risk for additional fracture and should benefit from targeted diagnostic and treatment procedures for osteoporosis. To address this issue, we set up an osteoporosis clinical pathway (OCP) for the medical management of patients with low-tr...

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Veröffentlicht in:Osteoporosis international 2002-01, Vol.13 (6), p.450-455
Hauptverfasser: CHEVALLEY, T, HOFFMEYER, P, BONJOUR, J.-P, RIZZOLI, R
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container_issue 6
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container_title Osteoporosis international
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creator CHEVALLEY, T
HOFFMEYER, P
BONJOUR, J.-P
RIZZOLI, R
description Patients with an osteoporotic fracture have at least a 2-fold risk for additional fracture and should benefit from targeted diagnostic and treatment procedures for osteoporosis. To address this issue, we set up an osteoporosis clinical pathway (OCP) for the medical management of patients with low-trauma fracture. Following acute management of the fracture by the orthopedic team, patients are enrolled in the pathway, which is based on an interaction between the OCP multidisciplinary team, orthopedic surgeons and/or primary care physicians. After collection of patient data, suggestions for additional diagnostic examinations with their interpretation, and treatment proposals are made. Patients and their families are also invited to attend a multidisciplinary interactive educational program on physical therapy, lifestyle habits and nutrition. During a 36-month period, 385 patients (311 women, 74 men; mean age +/- SD: 73.0 +/- 13.5 years; hip fracture 45%, ankle/tibia 24%, proximal humerus 8.6%, spine 5.5%, pelvis 3.9%, distal forearm 3.6%, other sites 17.4%) were enrolled in the OCP. An osteoporosis awareness questionnaire administered within 10 days of fracture showed that 73% of patients believed that their fracture was not related to the disease. Dual-energy X-ray absorptiometry, performed in 63% of patients, showed that 86% had low bone mass or osteoporosis. Specific antiosteoporotic therapy was proposed for 33% of patients in addition to calcium and vitamin D supplements, the latter suggested for 93%. A survey performed in 216 patients 6 months later, indicated that 63% of the suggested treatments had been prescribed and that 67% of this group were continuing treatment. Such a clinical pathway for the medical management of low-trauma fracture can help to identify patients with osteoporosis in a high-risk population, provide support to the orthopedic surgeon and/or the primary care physician for diagnostic and treatment procedures, and should significantly contribute to increase awareness of the disease in patients and their families.
doi_str_mv 10.1007/s001980200053
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subjects Accidental Falls
Aged
Aged, 80 and over
Biological and medical sciences
Bone density
Bone diseases
Calcium - administration & dosage
Diseases of the osteoarticular system
Estrogen Replacement Therapy
Female
Follow-Up Studies
Fractures
Fractures, Bone - diagnosis
Fractures, Bone - etiology
Fractures, Bone - prevention & control
Hip joint
Humans
Internal medicine
Male
Medical sciences
Middle Aged
Orthopedics
Osteoporosis
Osteoporosis - complications
Osteoporosis - drug therapy
Osteoporosis - psychology
Osteoporosis. Osteomalacia. Paget disease
Patient care planning
Patient Compliance
Patient Education as Topic
Primary care
Questionnaires
Surgeons
Trauma
Vitamin D - administration & dosage
title An osteoporosis clinical pathway for the medical management of patients with low-trauma fracture
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