A Simple Intervention for Improving the Implementation Rate of a Recommended Osteoporosis Treatment After Hip Fracture |
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| Affiliation: | 1. Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;2. Maccabi Healthcare Services, Israel;3. Center for Clinical Quality and Safety, Jerusalem, Israel;4. Endocrinology and Metabolism Service, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;1. Endocrinology and Metabolism Institute, Cleveland Clinic Foundation, Cleveland, Ohio;2. Education Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio;3. Yale Pediatric Endocrinology Department, Yale University School of Medicine, New Haven, Connecticut;4. Yale Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut;5. Pathology and Laboratory Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio;1. University of Maryland School of Medicine, Baltimore, Maryland;2. Baltimore Washington Medical Center Baltimore, Maryland;3. University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;4. Boston University Medical Center, Boston, Massachusetts;1. Sapienza University of Rome Experimental Medicine Department Medical Physiopathology, Food Science and Endocrinology Section Food Science and Human Nutrition Research Unit;1. Endocrinology Service, Experimental Endocrinology Unit, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social 11560 Mexico City, Mexico;;2. Departments of Medicine and Clinical Pathology, The American British Cowdray Medical Center.;1. Hattiesburg Clinic, Hattiesburg, Mississippis;2. Strelitz Diabetes Center for Endocrine and Metabolic Disorders, Eastern Virginia Medical School, Norfolk, Virginia |
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| Abstract: | ObjectiveOsteoporosis is often under-treated, and hip fracture is frequently its first manifestation. Hospitalization for a hip fracture is an opportunity to initiate osteoporosis treatment. The aim of this study was to investigate whether a simple intervention improves the implementation rate of a recommended osteoporosis treatment.MethodsOne hundred elderly patients admitted with low-impact hip fracture were given a 10 minute explanation about osteoporosis and its treatment during their postoperative hospital stay. In addition, the patients received an explanatory brochure and a letter to their primary care physician that included an article on fracture rate reduction with osteoporosis treatment. Implementation of therapy was assessed by a telephone survey 3 and 6 months postoperatively. The patients who had not received treatment at 3 months were given a repeated explanation. The historical control group was comprised of 100 hip fracture patients with similar demographic characteristics, who were operated on and discharged with the standard care recommendations for osteoporosis prevention.ResultsAt the 3 month follow-up, the therapy rate in both groups was similar (19%). Fifty-eight percent of the patients in the study group had no recollection of the intervention. However, after a repeated explanation, at the 6 month follow-up, 39% of the intervention group had received drug therapy for fracture prevention (P<.001).ConclusionA simple intervention enlisting the patients' help to involve their primary care physician can increase treatment rates for osteoporosis following a hip fracture. During the immediate postoperative period, the patients and their families have difficulty implementing the recommendations. Therefore, repeated communications are recommended. (Endocr Pract. 2013;19:46-50) |
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