Challenges in osteoporosis treatment initiation in geriatric patients admitted under the hip-fracture pathway

• Published in: Archives of osteoporosis 2022-12, Vol.17 (1), p.136-136, Article 136
• Main Authors: Wen, Angela Frances Yap Hui, Chong, Bernard Yap Kok, Joseph, Lissa Vazhayil, Bee, Joyce Koh Suang, Sen, Howe Tet, Mamun, Kaysar
• Format: Article
• Language: English
• Subjects: Aged; Bone Density Conservation Agents - therapeutic use; Calcium - therapeutic use; Endocrinology; Hip Fractures - complications; Humans; Medicine; Medicine & Public Health; Middle Aged; Original Article; Orthopedics; Osteoporosis - complications; Osteoporosis - drug therapy; Osteoporosis - epidemiology; Osteoporotic Fractures - complications; Retrospective Studies; Vitamin D - therapeutic use
• ISSN: 1862-3522; 1862-3514
• DOI: 10.1007/s11657-022-01179-6

Summary Osteoporosis is often untreated especially in older people. This study found a low prescribing rate of osteoporosis treatment medication of 22.4% in older people admitted under the hip-fracture pathway. Factors associated with greater odds of being prescribed osteoporosis medications are categorized into patient-related, physician-related and system-related factors. Introduction Osteoporosis represents a growing healthcare problem which is often overlooked by healthcare providers and untreated especially in older people. This study aims to assess the rate of osteoporosis treatment initiation and to investigate underlying physician and system-related barriers in geriatric patients admitted for hip fracture. Methods A retrospective study was conducted on patients aged 60 years and older, admitted under the hip-fracture pathway from January 2019 to December 2019. Data collected included demographics, co-morbid conditions and laboratory data. Clinical charts were reviewed for whether bone mineral density (BMD) scan has been ordered, plans for bone health were made and reflected in the discharge summary, and if appropriate memos were written. The primary outcome was the prescription of osteoporosis treatment medications. Prescription lists were also reviewed for prescribing patterns of calcium and vitamin D. Results A total of 375 patients older than 60 years old were identified. 281 patients who fit the inclusion and exclusion criteria with complete data were further analysed. Within 1 year of hip fracture admission, 63 (22.4%) of them were prescribed with osteoporosis treatment. Multivariate logistic regression identified milder stage of CKD ( p  = 0.038, OR  = 0.617, 95% CI 0.392–0.973) and BMD scan performed ( p