Effect of hospitalist consultation on treatment of osteoporosis in hip fracture patients. Osteoporos Int 2003 Aug;14(8):665-71
Date
07/25/2003Pubmed ID
12879218DOI
10.1007/s00198-003-1413-4Scopus ID
2-s2.0-0142228233 (requires institutional sign-in at Scopus site) 23 CitationsAbstract
The objective of this study was to determine if hospitalist consultation during admission for hip fracture results in improved treatment for osteoporosis. This was a retrospective chart review, carried out in a university-based academic hospital. Administrative discharge data was used to identify patients discharged between 1 September 1999 and 1 September 2001, discharged with the diagnosis of hip fracture. Eighty-two patient charts were reviewed after exclusion for traumatic and pathologic fractures. Treatment for osteoporosis consisted of medications recommended by the National Osteoporosis Foundation (NOF), including calcium (+/-vitamin D), estrogen, raloxifene, calcitonin, alendronate and risedronate. Osteoporosis treatment improvement was defined as the addition of a medication for osteoporosis that strengthened treatment. Twenty-nine percent of patients in our study received treatment for osteoporosis at the time of discharge from the hospitalization for hip fracture. While 20% received calcium, only 7% received a bisphosphonate. Twelve percent received improvement in osteoporosis treatment from admission to discharge. Those that received hospitalist consultation did not have a significant improvement in osteoporosis treatment (P=0.314), but had significantly more co-morbid illnesses and were significantly older than those receiving no consultation (P<0.05). Identification of osteoporosis as a medical problem was significantly associated with osteoporosis treatment (P<0.05). Potential barriers to hospitalist consultation's effect on osteoporosis treatment included patient age and co-morbidities. Further research is needed to identify and overcome barriers to effective osteoporosis treatment in patients with fractures.
Author List
Jachna CM, Whittle J, Lukert B, Graves L, Bhargava TAuthor
Jeffrey Whittle MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedCalcium
Drug Utilization
Female
Hip Fractures
Hospitalists
Hospitalization
Humans
Kansas
Male
Middle Aged
Osteoporosis
Referral and Consultation
Retrospective Studies
Risk Factors
