Scientists are calling for further research into reasons why osteoporosis is undertreated by primary care providers, after showing that only a third of patients with fracture history have their osteoporosis properly managed.
The incidence of hip fracture is predicted to increase worldwide, and in Australia, where the current study was conducted, it is estimated that incidence rates will increase from one per 6 minutes currently to one every 3 minutes by 2021.
The clinical and economic burden associated with hip fracture is best addressed by primary care providers, since they are ideally placed to identify and manage osteoporosis early, say the investigators.
Noting the importance of effective primary care in addressing the growing hip fracture burden, Philip Sambrook (Royal North Shore Hospital, Sydney, Australia) and associates questioned 37,957 randomly-selected individuals seen by 1258 general practitioners in Australia over a 12-month period.
Patients ranged in age from 40 to 104 years, but were aged 71 years on average. Just over half the patients were female and 79.6% of these women were post-menopausal.
Overall, 12.6% of the patients had previously suffered minimal trauma fracture, while 7.5% had a family history of osteoporosis. Other osteoporosis risk factors observed included smoking (7.4%), low dietary calcium intake (11.4%), lack of exercise (31.8%), and use of glucocorticoids (10.3%).
The investigators report that only 9.6% of those interviewed were taking medication or supplements specifically to prevent osteoporosis. Indeed, even amongst patients who declared a history of fracture only 29.7% were taking anti-osteoporosis medication. Radiography of 17,754 of the study participants revealed that actual, rather than patient-reported, vertebral fracture rates were closer to 30.0%, but that only 3.8% of those with evidence of fracture were using osteoporosis medication.
Summarizing these results in the journal Osteoporosis International, the authors write: "Despite effective treatments now being readily available for secondary prevention of fractures, this study suggests evidence based care is not being implemented or instituted by general practitioners in Australia."
Discussing practical approaches to dealing with under-treatment, the researchers recommend "increased education of patients and general practitioners as well as specific chronic disease programs to enhance treatment rates in primary care."
Interesting article. Thanks for sharing!Excellent article! I just found out this year that I have osteoporosis. As I've mentioned here before, I broke the left side of my pelvis in Jan-Feb, we still don't know exactly how. Then in May I fell at home and broke the other side in two places. The second time, I ended up in a nursing home for a week, 'til I threw a fit and demanded to go home!