Diagnosis and treatment of osteoporosis in patients with vertebral compression fractures. J Am Geriatr Soc 2003 Apr;51(4):483-91
Date
03/27/2003Pubmed ID
12657067DOI
10.1046/j.1532-5415.2003.51156.xScopus ID
2-s2.0-0037394055 (requires institutional sign-in at Scopus site) 43 CitationsAbstract
OBJECTIVES: To determine whether patients with vertebral compression fractures are diagnosed with or treated for osteoporosis.
DESIGN: Retrospective cohort study.
SETTING: Two primary care practices in Massachusetts.
PARTICIPANTS: Two hundred six patients with vertebral compression fractures noted on routine radiographs in 1997-1998.
MEASUREMENTS: Percentage of patients diagnosed with osteoporosis and treated with prescription medications (estrogen, bisphosphonates, raloxifene, or calcitonin). Factors associated with missed osteoporosis diagnosis and treatment, including risk factors for osteoporosis, comorbidities, vertebral fracture severity, and processes of care communication were also examined.
RESULTS: The median patient age was 76, 71% of the cohort was female, and 13% of patients had a history of corticosteroid use. Thirty-eight percent of subjects (46% of women and 19% of men) were diagnosed with osteoporosis and 32% (39% of women and 14% of men) received prescription medications for osteoporosis. Of women who were diagnosed with osteoporosis, 69% received prescription medications. In adjusted analyses women younger than 50 (adjusted odds ratio (AOR) = 0.09; 95% confidence interval (CI) = 0.01-0.71) and 90 and older (AOR = 0.27; 95% CI = 0.08-0.98) were less likely to be diagnosed with osteoporosis, whereas women with a prior hip or radial fracture (AOR = 3.65; 95% CI = 1.28-10.38) or back pain (AOR = 2.84; 95% CI = 1.38-5.85) were more likely to be diagnosed with osteoporosis.
CONCLUSIONS: Physicians frequently did not diagnose osteoporosis in primary care patients with vertebral fractures, missing an important preventive opportunity for patients at high risk for future fractures. Efforts targeted to improving diagnosis of osteoporosis could improve patient care.
Author List
Neuner JM, Zimmer JK, Hamel MBAuthor
Joan Neuner MD, MPH Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Female
Fractures, Bone
Health Services for the Aged
Humans
Male
Massachusetts
Middle Aged
Osteoporosis
Quality of Health Care
Retrospective Studies
Risk Factors
Social Class
