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Influence of fracture history and bone mineral density testing on the treatment of osteoporosis in two non-academic community centers
- Source :
- Osteoporosis International. 16:208-215
- Publication Year :
- 2004
- Publisher :
- Springer Science and Business Media LLC, 2004.
-
Abstract
- A history of fracture and a low bone mineral density (BMD) are the strongest predictors of future osteoporotic fracture. This prospective cohort study assessed the impact of these two factors on treatment patterns in women undergoing their first BMD testing in a non-academic community setting. Successive women seen for first BMD testing at two testing centers completed a baseline questionnaire and a mailed 3-month follow-up questionnaire. Patients were grouped by history of fracture after age 20 years (present, absent) and by BMD result [osteoporosis (OP), osteopenia (OPN), normal BMD]. Thirty percent of 1144 patients at least 45 years old reported a history of fracture after age 20 years. They were no more likely than those without a history of fracture to be taking calcium (52% of total), vitamin D (31%), estrogen (31%), or a bisphosphonate (2%) before BMD testing. The BMD testing revealed OP in 20%, OPN in 45%, and normal BMD in 35%. Three months later, the percentages of patients taking treatments differed as follows: calcium (66 vs 53% in OP and OPN groups vs normal BMD), vitamin D (46 vs 37% in OPN group vs normal BMD), estrogen (25 vs 36 vs 44% in groups with OP, OPN, and normal BMD), a bisphosphonate (43 vs 11 vs 1%), and at least one of estrogen or a bisphosphonate (58 vs 43 vs 46%). Treatment decisions were influenced by first BMD testing but not significantly by a history of fracture. There is a substantial care gap in the treatment of patients with OP: either bisphosphonate or estrogen therapy was taken by only 31% of patients at least 45 years old and with a history of fracture after age 20 years before BMD testing and by only 58% of these and who also had OP by BMD.
- Subjects :
- Adult
musculoskeletal diseases
Health Knowledge, Attitudes, Practice
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Osteoporosis
Fractures, Bone
Bone Density
Internal medicine
medicine
Vitamin D and neurology
Humans
Prospective Studies
Vitamin D
Prospective cohort study
Bone mineral
Alendronate
business.industry
musculoskeletal, neural, and ocular physiology
Age Factors
Estrogens
Etidronic Acid
Middle Aged
Bisphosphonate
musculoskeletal system
medicine.disease
Rheumatology
Surgery
Calcium, Dietary
Osteopenia
Bone Diseases, Metabolic
Logistic Models
Orthopedic surgery
Female
business
Subjects
Details
- ISSN :
- 14332965 and 0937941X
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Osteoporosis International
- Accession number :
- edsair.doi.dedup.....a8bdec4391ed527387c6b8707796ef14