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Under-Recognition of Fractures as Osteoporosis Indicators

After the first fracture, the risk of subsequent fractures increases significantly. Medical treatment can reduce the risk of a second fracture by about 50%, but many older adults do not receive osteoporosis medication following their first fracture. This observational study aimed to understand prima...

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Autores principales: Lagari, Violet S., Al-Yatama, Fatima, Rodriguez, Gracielena, Berger, Hara R., Levis, Silvina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473876/
https://www.ncbi.nlm.nih.gov/pubmed/31023977
http://dx.doi.org/10.3390/geriatrics4010009
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author Lagari, Violet S.
Al-Yatama, Fatima
Rodriguez, Gracielena
Berger, Hara R.
Levis, Silvina
author_facet Lagari, Violet S.
Al-Yatama, Fatima
Rodriguez, Gracielena
Berger, Hara R.
Levis, Silvina
author_sort Lagari, Violet S.
collection PubMed
description After the first fracture, the risk of subsequent fractures increases significantly. Medical treatment can reduce the risk of a second fracture by about 50%, but many older adults do not receive osteoporosis medication following their first fracture. This observational study aimed to understand primary care management patterns of older adults after osteoporotic fractures at the Miami Veterans Affairs (VA) Healthcare System. A retrospective review of 219 fracture cases selected by International Classification of Disease (ICD-9) codes between October 2015 and September 2016 identified 114 individuals age ≥50 years who had a non-traumatic fracture code entered in their medical record for the first time. Among them, 72 (63%) did not undergo a bone mineral density (BMD) test or receive treatment in the 12 months following their fracture. Of the 40 individuals who had a BMD test post-fracture, 17 (100%) received or were considered for anti-osteoporosis treatment if their T-score indicated osteoporosis (T-score ≤−2.5), but only 8/23 (35%) if the T-score was >−2.5. Physicians are more likely to prescribe osteoporosis therapy based on a BMD T-score diagnosis of osteoporosis, rather than a clinical diagnosis of osteoporosis based on a low-trauma fracture. A change in practice patterns is necessary to decrease the incidence of fractures.
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spelling pubmed-64738762019-05-02 Under-Recognition of Fractures as Osteoporosis Indicators Lagari, Violet S. Al-Yatama, Fatima Rodriguez, Gracielena Berger, Hara R. Levis, Silvina Geriatrics (Basel) Article After the first fracture, the risk of subsequent fractures increases significantly. Medical treatment can reduce the risk of a second fracture by about 50%, but many older adults do not receive osteoporosis medication following their first fracture. This observational study aimed to understand primary care management patterns of older adults after osteoporotic fractures at the Miami Veterans Affairs (VA) Healthcare System. A retrospective review of 219 fracture cases selected by International Classification of Disease (ICD-9) codes between October 2015 and September 2016 identified 114 individuals age ≥50 years who had a non-traumatic fracture code entered in their medical record for the first time. Among them, 72 (63%) did not undergo a bone mineral density (BMD) test or receive treatment in the 12 months following their fracture. Of the 40 individuals who had a BMD test post-fracture, 17 (100%) received or were considered for anti-osteoporosis treatment if their T-score indicated osteoporosis (T-score ≤−2.5), but only 8/23 (35%) if the T-score was >−2.5. Physicians are more likely to prescribe osteoporosis therapy based on a BMD T-score diagnosis of osteoporosis, rather than a clinical diagnosis of osteoporosis based on a low-trauma fracture. A change in practice patterns is necessary to decrease the incidence of fractures. MDPI 2019-01-09 /pmc/articles/PMC6473876/ /pubmed/31023977 http://dx.doi.org/10.3390/geriatrics4010009 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lagari, Violet S.
Al-Yatama, Fatima
Rodriguez, Gracielena
Berger, Hara R.
Levis, Silvina
Under-Recognition of Fractures as Osteoporosis Indicators
title Under-Recognition of Fractures as Osteoporosis Indicators
title_full Under-Recognition of Fractures as Osteoporosis Indicators
title_fullStr Under-Recognition of Fractures as Osteoporosis Indicators
title_full_unstemmed Under-Recognition of Fractures as Osteoporosis Indicators
title_short Under-Recognition of Fractures as Osteoporosis Indicators
title_sort under-recognition of fractures as osteoporosis indicators
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473876/
https://www.ncbi.nlm.nih.gov/pubmed/31023977
http://dx.doi.org/10.3390/geriatrics4010009
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