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Introduction of an order set after hip fracture improves osteoporosis medication initiation and persistence: a population-based before-after analysis.
- Source :
-
Osteoporosis International . Oct2024, Vol. 35 Issue 10, p1729-1736. 8p. - Publication Year :
- 2024
-
Abstract
- Summary: We found that a standardized order set after hip fracture increased initiation of anti-osteoporosis medication and increased persistence at 1 year, but did not reduce secondary fractures. Background: A treatment gap exists after osteoporosis-related fractures. Introducing standardized care can improve treatment. We evaluated the impact of a hip fracture order set (OS) on anti-osteoporosis medication (AOM) initiation, persistence, and secondary fracture prevention. Methods: In 2015, one hospital in Manitoba, Canada, introduced a hip fracture OS including recommendations for the initiation of AOM (OS group). A control group was identified from the other hospitals in the same region. A retrospective cohort study was conducted using linked administrative health data. All individuals 50 + years with surgical treatment for low-energy hip fracture between 2010 and 2019 were included and followed for AOM initiation, medication persistence at 1 year, and secondary fractures. Between-group differences for each year were assessed using chi-square tests. Logistic regression models tested the impact of socio-demographic and clinical factors on initiation, persistence of AOM. Cox regression tested the risk of secondary fracture. Results: No baseline differences between OS group (813 patients) and control group (2150 patients) were observed in demographics, socioeconomic factors, or comorbidities. An increase in post-fracture AOM initiation was seen with OS introduction (OS group year before 16.7% versus year after 48.6%, p < 0.001). No change was seen in the control group. Persistence on AOM also increased (OS group year before 17.7% versus year after 28.4%, p < 0.001). No difference in secondary fractures was observed (OS group 19.8% versus control group 18.8%, p = 0.38). Conclusion: Introduction of a hip fracture OS significantly increased AOM initiation and persistence at 1-year post-fracture. There was no significant difference in secondary fractures. [ABSTRACT FROM AUTHOR]
- Subjects :
- *OSTEOPOROSIS prevention
*THERAPEUTIC use of vitamin D
*BONE fracture prevention
*PATIENT compliance
*HIP fractures
*DIPHOSPHONATES
*RESEARCH funding
*LOGISTIC regression analysis
*HOSPITALS
*RETROSPECTIVE studies
*CHI-squared test
*DESCRIPTIVE statistics
*CALCIUM
*LONGITUDINAL method
*MEDICAL records
*ACQUISITION of data
*OSTEOPOROSIS
*DRUGS
*COMPARATIVE studies
*SOCIODEMOGRAPHIC factors
*POSTOPERATIVE period
*PREVENTIVE health services
*PROPORTIONAL hazards models
Subjects
Details
- Language :
- English
- ISSN :
- 0937941X
- Volume :
- 35
- Issue :
- 10
- Database :
- Academic Search Index
- Journal :
- Osteoporosis International
- Publication Type :
- Academic Journal
- Accession number :
- 179948131
- Full Text :
- https://doi.org/10.1007/s00198-024-07131-3