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Low prevalence of osteoporosis treatment in patients with recurrent major osteoporotic fracture

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Abstract

Summary

The majority of patients do not receive anti-osteoporotic treatment following a major osteoporotic fracture, despite the guidelines and the availability of effective anti-osteoporotic treatments. The fight against factors limiting the diagnosis and treatment of osteoporosis should become a priority to improve secondary prevention after an initial osteoporotic fracture.

Purpose

Despite the availability of effective anti-osteoporotic treatments, osteoporosis management is currently insufficient. The main objective of this study was to assess the prevalence of anti-osteoporotic treatments introduced after an initial prior major osteoporotic fracture during hospitalization for recurring fractures.

Methods

We conducted an observational, cross-sectional, bicentric study that included all patients aged over 50 years who were hospitalized or seen in consultation for major osteoporotic fracture.

Results

One hundred twenty-eight out of two hundred four (62.7%) patients had a past history of major osteoporotic fracture and therefore had an indication of treatment based on guidelines. Among these patients, only 43/128 (33.5%) had received anti-osteoporotic treatment as secondary prevention after the initial fracture. The main causes of non-prescription identified were the attending physicians’ ignorance of the indication of treatment (n = 30; 35.3%), ignorance of the fracture (n = 17; 20%), and comorbidities (n = 12; 14.1%). The failure to introduce treatment was associated with the presence of comorbidities with a Charlson Comorbidity Index ≥6 (OR = 0.34 [0.16–0.73], p < 0.05), dementia (OR = 0.23 [0.08–0.72], p < 0.05), and past history of proximal femur fracture (OR = 0.20 [0.04–0.91], p < 0.05).

Conclusions

Two thirds of patients with a past history of major osteoporotic fracture presenting with a new fracture were not treated. The main reason for lack of treatment seems to stem from the incorrect assessment of the patient’s fracture risk. Although major osteoporotic fracture leads to an increased risk of mortality and requires treatment, the significance of patient comorbidities was an independent risk factor leading to non-treatment.

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Authors and Affiliations

  1. Service de Rhumatologie, Centre Hospitalier Universitaire de Rennes, Hôpital Sud, 16, B.D de Bulgarie, 35 203, Rennes, France

    J. Flais, G. Coiffier, J. D. Albert, M. Faccin, A. Perdriger & P. Guggenbuhl

  2. Université de Rennes 1, 35 043, Rennes, France

    J. Flais, G. Coiffier, J. D. Albert, M. Faccin, A. Perdriger, H. Thomazeau & P. Guggenbuhl

  3. Service de Rhumatologie, Centre Hospitalier Régional de Lorient, 56 322, Lorient, France

    J. Le Noach

  4. Service de Chirurgie Orthopédique, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 35 043, Rennes, France

    H. Thomazeau

  5. INSERM UMR 991, 35 000, Rennes, France

    P. Guggenbuhl

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  1. J. Flais
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  2. G. Coiffier
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  3. J. Le Noach
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  4. J. D. Albert
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  5. M. Faccin
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  6. A. Perdriger
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  8. P. Guggenbuhl
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Corresponding author

Correspondence to J. Flais.

Ethics declarations

The study was approved by the ethics committee of Rennes University Hospital (Opinion No. 15.105) and of Lorient Hospital (Opinion No. 2016.02).

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Flais, J., Coiffier, G., Le Noach, J. et al. Low prevalence of osteoporosis treatment in patients with recurrent major osteoporotic fracture. Arch Osteoporos 12, 24 (2017). https://doi.org/10.1007/s11657-017-0317-4

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  • DOI: https://doi.org/10.1007/s11657-017-0317-4

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