The Osteoporosis Care Gap in Canada

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2004 Apr 8

PMID 15068488

Citations 69

Authors

A Papaioannou

L Giangregorio

B Kvern

P Boulos

G Ioannidis

J D Adachi

Affiliations

Soon will be listed here.

Abstract

Background: The presence of a fragility fracture is a major risk factor for osteoporosis, and should be an indicator for osteoporosis diagnosis and therapy. However, the extent to which patients who fracture are assessed and treated for osteoporosis is not clear.

Methods: We performed a review of the literature to identify the practice patterns in the diagnosis and treatment of osteoporosis in adults over the age of 40 who experience a fragility fracture in Canada. Searches were performed in MEDLINE (1966 to January 2, 2003) and CINAHL (1982 to February 1, 2003) databases.

Results: There is evidence of a care gap between the occurrence of a fragility fracture and the diagnosis and treatment of osteoporosis in Canada. The proportion of individuals with a fragility fracture who received an osteoporosis diagnostic test or physician diagnosis ranged from 1.7% to 50%. Therapies such as hormone replacement therapy, bisphosphonates or calcitonin were being prescribed to 5.2% to 37.5% of patients. Calcium and vitamin D supplement intake was variable, and ranged between 2.8% to 61.6% of patients.

Conclusion: Many Canadians who experience fragility fracture are not receiving osteoporosis management for the prevention of future fractures.

Citing Articles

Factors Associated With Nonattendance for Osteoporosis Evaluation Following Fragility Fracture.

Seyok T, Collins J, Hodys C, Erikson S, Perez Menendez S, Earp B J Osteoporos. 2024; 2024:5602020.

PMID: 39650280 PMC: 11625084. DOI: 10.1155/joos/5602020.

Exploring barriers and opportunities to improve osteoporosis care across the acute-to-primary care interface: a qualitative study.

Bennett M, Center J, Perry L Osteoporos Int. 2023; 34(7):1249-1262.

PMID: 37093239 PMC: 10281902. DOI: 10.1007/s00198-023-06748-0.

Treatment rates and healthcare costs of patients with fragility fracture by site of care: a real-world data analysis.

Singer A, McClung M, Tran O, Morrow C, Goldstein S, Kagan R Arch Osteoporos. 2023; 18(1):42.

PMID: 36905559 PMC: 10008255. DOI: 10.1007/s11657-023-01229-7.

The association between multimorbidity and osteoporosis investigation and treatment in high-risk fracture patients in Australia: A prospective cohort study.

Bliuc D, Tran T, Chen W, Alarkawi D, Alajlouni D, Blyth F PLoS Med. 2023; 20(1):e1004142.

PMID: 36649234 PMC: 9844893. DOI: 10.1371/journal.pmed.1004142.

Hip fracture predicts subsequent hip fracture: a retrospective observational study to support a call to early hip fracture prevention efforts in post-fracture patients.

Schemitsch E, Adachi J, Brown J, Tarride J, Burke N, Oliveira T Osteoporos Int. 2021; 33(1):113-122.

PMID: 34379148 PMC: 8354846. DOI: 10.1007/s00198-021-06080-5.

References

Ridout R, Hawker G . Use of bone densitometry by Ontario family physicians. Osteoporos Int. 2000; 11(5):393-9. DOI: 10.1007/s001980070105. View

Davis J, Grove J, Wasnich R, Ross P . Spatial relationships between prevalent and incident spine fractures. Bone. 1999; 24(3):261-4. DOI: 10.1016/s8756-3282(98)00176-8. View

Hajcsar E, Hawker G, Bogoch E . Investigation and treatment of osteoporosis in patients with fragility fractures. CMAJ. 2000; 163(7):819-22. PMC: 80503. View

Fitt N, Mitchell S, Cranney A, Gulenchyn K, Huang M, Tugwell P . Influence of bone densitometry results on the treatment of osteoporosis. CMAJ. 2001; 164(6):777-81. PMC: 80872. View

Khan S, de Geus C, Holroyd B, Russell A . Osteoporosis follow-up after wrist fractures following minor trauma. Arch Intern Med. 2001; 161(10):1309-12. DOI: 10.1001/archinte.161.10.1309. View

Castel H, Bonneh D, Sherf M, Liel Y . Awareness of osteoporosis and compliance with management guidelines in patients with newly diagnosed low-impact fractures. Osteoporos Int. 2001; 12(7):559-64. DOI: 10.1007/s001980170077. View

Bellantonio S, Fortinsky R, Prestwood K . How well are community-living women treated for osteoporosis after hip fracture?. J Am Geriatr Soc. 2001; 49(9):1197-204. DOI: 10.1046/j.1532-5415.2001.49237.x. View

Juby A, Davis P . A prospective evaluation of the awareness, knowledge, risk factors and current treatment of osteoporosis in a cohort of elderly subjects. Osteoporos Int. 2001; 12(8):617-22. DOI: 10.1007/s001980170060. View

Onder G, Pedone C, Gambassi G, Landi F, Cesari M, Bernabei R . Treatment of osteoporosis among older adults discharged from hospital in Italy. Eur J Clin Pharmacol. 2002; 57(8):599-604. DOI: 10.1007/s002280100370. View

10.

Riley R, Carnes M, Gudmundsson A, Elliott M . Outcomes and secondary prevention strategies for male hip fractures. Ann Pharmacother. 2002; 36(1):17-23. DOI: 10.1345/aph.1A094. View

11.

Lee L, Drake W, Kendler D . Intake of calcium and vitamin D in 3 Canadian long-term care facilities. J Am Diet Assoc. 2002; 102(2):244-7. DOI: 10.1016/s0002-8223(02)90057-x. View

12.

Cuddihy M, Gabriel S, Crowson C, Atkinson E, Tabini C, OFallon W . Osteoporosis intervention following distal forearm fractures: a missed opportunity?. Arch Intern Med. 2002; 162(4):421-6. DOI: 10.1001/archinte.162.4.421. View

13.

Juby A . Evaluation of osteoporosis treatment in seniors after hip fracture. Osteoporos Int. 2002; 13(3):205-10. DOI: 10.1007/s001980200015. View

14.

Rucker D, Allan J, Fick G, Hanley D . Vitamin D insufficiency in a population of healthy western Canadians. CMAJ. 2002; 166(12):1517-24. PMC: 113796. View

15.

Hellekson K . NIH releases statement on osteoporosis prevention, diagnosis, and therapy. Am Fam Physician. 2002; 66(1):161-2. View

16.

Gardner M, Flik K, Mooar P, Lane J . Improvement in the undertreatment of osteoporosis following hip fracture. J Bone Joint Surg Am. 2002; 84(8):1342-8. DOI: 10.2106/00004623-200208000-00008. View

17.

Papaioannou A, Watts N, Kendler D, Yuen C, Adachi J, Ferko N . Diagnosis and management of vertebral fractures in elderly adults. Am J Med. 2002; 113(3):220-8. DOI: 10.1016/s0002-9343(02)01190-7. View

18.

Kiebzak G, Beinart G, Perser K, Ambrose C, Siff S, Heggeness M . Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med. 2002; 162(19):2217-22. DOI: 10.1001/archinte.162.19.2217. View

19.

Brown J, Josse R . 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ. 2002; 167(10 Suppl):S1-34. PMC: 134653. View

20.

Simonelli C, Chen Y, Morancey J, Lewis A, Abbott T . Evaluation and management of osteoporosis following hospitalization for low-impact fracture. J Gen Intern Med. 2003; 18(1):17-22. PMC: 1494813. DOI: 10.1046/j.1525-1497.2003.20387.x. View