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Purpose: Despite the high morbidity and mortality rate of osteoporosis, the proportion of patients who receive appropriate diagnosis and treatment remains very low. A specific osteoporosis program increased the percentage of patients receiving diagnosis and/or treatment for osteoporosis. We set up a program to improve diagnosis and treatment of patients with low-trauma fractures or suspicion of osteoporosis., Methods: Two geriatricians were especially designated for this program. The program included patients admitted to the emergency room, inpatients and outpatients from the orthopedic department or the internal medicine/geriatric department. The assessment was performed over two visits and included an evaluation of risk factors for osteoporosis and falls, a physical examination, a collection of biological parameters, and Dual-energy X-ray absorptiometry. In the second visit the physician prescribed, if appropriate, anti-osteoporotic treatment., Results: During a two-year period, 156 patients were included in the program; 85.4 % were women. Hip fracture was the most common fracture, followed by vertebral and arm (respectively 28.6%, 11.5%, and 7.6%). While half the patients had a personal history of low-trauma fractures, only 17% received osteoporosis treatment. Anti-osteoporotic treatments were prescribed for 49% of the patients (p<0.001). It was mainly vitamin D (35%), calcium supplementation (31.2%), and oral bisphosphonate (23.6%). Inclusion in our program increased the number of patients receiving anti-osteoporotic treatment from 17.2 to 49.7%. All fallers received falls - prevention counseling based on written materials and oral information., Conclusion: A specific program increases the percentage of patients receiving diagnosis and treatment for osteoporosis for patients with low-trauma fractures or suspicion of osteoporosis. Our next objectives are to develop this program to other health care's professionals.

Introduction: In the elderly, both the presence of a multiple pathology and multiple medication have been shown to be frequent risk factors for adverse drug events. However, a few studies only have included parameters of standardized geriatric assessment for the purpose of identifying other risk factors. Our study compared the parameters of standard geriatric assessment, in the presence or absence of adverse drug events and evaluated the prevalence of adverse drug events in elderly inpatients, the symptoms, and the drugs involved., Methods: A total of 823 patients were studied during a two-year period. Two groups of patients were identified, according to the presence or absence of an adverse drug event. Eight fields of geriatric assessment were compared: comorbidities, number of drugs, functional status, nutritional status, mobility, mood, neurosensory disorders, and cognition. For patients who experienced an adverse drug event, we also analyzed the drugs involved and the symptoms of the adverse drug events., Results: One hundred and twelve patients (13.6%) aged 82 years+/-7.5 experienced 144 adverse drug events. Significant differences between the two groups were observed in the following: symptoms of depression, problems of mobility, risk of malnutrition (respectively p=0.001, p=0.002, p=0.007), the female sex, number of drugs, number of comorbidities, and the administration of diuretics. Cardiovascular (23.2%), psychotropic (17.9%) and anti-infectious (17%) medicines were the most frequently involved. The symptoms that occurred most frequently were orthostatic hypotension (14.6%), gastrointestinal disorders (12.5%), and neuropsychological (10.4%) disorders., Conclusion: Elderly patients with multiple pathology and multiple medication are at high risk for adverse drug events. Other lesser known factors, such as depression, problems of mobility, and malnutrition must be researched, as they are evidence of the underlying the frailty of the elderly population.