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 “Osteoporosis screening after hip fracture is so important because
there are a number of highly effective and relatively low-risk
treatments available that can substantially reduce future fracture
risk,” said lead study author Catherine Gillespie of the AARP Public
Policy Research Institute and George Washington University in
Washington, D.C.
For the study, researchers examined insurance data on medical care
and prescription use for 8,359 women over 50 who had a hip fracture
between 2008 and 2013.
None of the women had a prior history of osteoporosis, hip fracture,
or taking medications to improve bone density.
More than half of the women in the study were at least 80 years old
when they first fractured their hip. Most had multiple chronic
medical problems.
Within six months of experiencing their first hip fracture, just 17
percent of the women got tested for osteoporosis or received a
treatment for the condition, researchers report in the Journal of
Bone and Mineral Research.
After one year, only 23 percent of the women had been screened or
put on treatment for osteoporosis.
During the study period, use of bone mass measurement tests
increased among women 65 and older but declined among women from 50
to 64.
Over the same timeframe, the rate of osteoporosis drug use remained
constant for women aged 50 to 64 but declined among older women in
the study.
Seeing a primary care doctor after fracture was the strongest and
most consistent predictor of osteoporosis assessment or treatment,
the study found. Women with private health insurance and higher
income also appeared more likely to get screening and treatment.
One limitation of the study is that researchers lacked data on women
who were uninsured or covered by Medicaid, the government health
program for the poor.
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They also lacked data on some interventions used to strengthen bones
and help prevent future falls such as calcium and vitamin D
supplements, counseling on exercise and fall prevention, or home
repairs and modifications to make day-to-day life safer to navigate.
Even so, the study confirms a long recognized gap in routine
osteoporosis care for patients with hip fractures, said Dr. Matthew
Drake, a researcher at the Mayo Clinic in Rochester, Minnesota, who
wasn’t involved in the study.
“Almost all patients who have a hip fracture should be screened for
osteoporosis as this will allow their provider to assess their bone
mineral density, and will also establish a baseline so that if
pharmacologic or other treatment approaches are chosen there is data
against which to compare later in order to determine how the therapy
is working,” Drake said by email.
“If a woman or man has a hip fracture, she/he should speak with
her/his doctor about getting screened for osteoporosis and strongly
consider starting therapy,” Drake added. “As this study clearly
shows, this screening and treatment continues to occur at a rate
which is abysmal.”
SOURCE: http://bit.ly/2m4InBt Journal of Bone and Mineral Research,
online February 23, 2017.
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