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Archives of Osteoporosis

, 14:95 | Cite as

Low rate of densitometric diagnosis and treatment in patients with severe osteoporosis in Colombia

  • Daniel G. Fernández-ÁvilaEmail author
  • Diana N. Rincón-Riaño
  • Diego F. Pinzón
  • Juan M. Gutiérrez Dávila
Short Communication
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Abstract

Summary

Our study describes the clinical characteristics of patients with fragility fractures. It also shows there is a low knowledge about osteoporosis and its relation to fractures, in addition to the very poor adherence to medical advice and treatment.

Introduction

Osteoporosis is a systemic skeletal disease associated with an increased risk of fragility fractures and is a public health problem worldwide due to population aging. Early osteoporosis diagnosis and treatment is very important for reducing the incidence of fragility fractures and the resulting complications. Our study describes the clinical characteristics of patients with fragility fractures and their risk factors, evaluates the level of knowledge that patients have about osteoporosis, and follows-up on each case to establish if, after the fracture, a densitometric diagnosis was made and the patient received specific treatment in his outpatient follow-up through his health insurance plan.

Methods

A descriptive cross-sectional study was carried out in a university hospital in Bogotá, Colombia. The data was collected by means of a questionnaire, administered to all patients admitted by the orthopedic emergency department with a diagnosis of fragility fracture. After discharge, a telephone follow-up was done every 3 months for 1 year, and patients were asked if they had already had the dual X-ray absorptiometry (DXA) scan and if they had begun osteoporosis treatment.

Results

A total of 111 patients with an average age of 74.4 years (± 11.3 years), of which 84 (75.6%) were women, all consulted for osteoporotic fracture at the orthopedic emergency department of the hospital. Hip fracture was the most frequent (51.4%), followed by vertebral (23.4%), wrist (22.5%), and humerus (4.5%) fracture. A total of 49.5% (n = 55) of the patients did not know what osteoporosis is; 58.6% (n = 65) did not know that fracture is the main complication of this disease, and 62.2% (n = 69) did not associate fractures with osteoporosis. All patients were educated about osteoporosis and the importance of diagnosing and treating it. Patients were given a medical order to have a DXA scan upon discharge; however, only 24.3% (n = 27) had the DXA scan in the first year of the fracture. A total of 33.3% (n = 37) received calcium plus vitamin D, and only 9.9% (n = 11) received osteoporosis treatment (7 bisphosphonate patients and 4 denosumab). No patient received osteoformative therapy.

Conclusions

Our study shows that Colombian patients have little knowledge about osteoporosis and its relationship with fragility fractures. It also shows that densitometries are not done and, what is worse, patients with a diagnosis of fracture have limited access to treatment after discharge.

Keywords

Osteoporosis Osteoporosis fracture Fragility fractures Colombia 

Notes

Compliance with ethical standards

The work was approved by the Clinical and Ethical Research Committee of the Pontificia Universidad Javeriana in Bogotá, Colombia.

Conflicts of interest

None.

References

  1. 1.
    NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy D and T (2001) Osteoporosis prevention, diagnosis, and therapy. JAMA J Am Med Assoc 285(6):785–795CrossRefGoogle Scholar
  2. 2.
    Cooper C, Campion G, Melton LJ (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2(6):285–289CrossRefGoogle Scholar
  3. 3.
    Marks R (2010) Hip fracture epidemiological trends, outcomes, and risk factors, 1970-2009. Int J Gen Med 3:1–17PubMedPubMedCentralGoogle Scholar
  4. 4.
    Zanchetta J et al (2012) The latin america regional audit: Epidemiología, costos e impacto de la osteoporosis en 2012. [cited 2019 Mar 24]. p. 33–5. Available from: www.iofbonehealth.org
  5. 5.
    Clark P, Cons-Molina F, Deleze M, Ragi S, Haddock L, Zanchetta JR, Jaller JJ, Palermo L, Talavera JO, Messina DO, Morales-Torres J, Salmeron J, Navarrete A, Suarez E, Pérez CM, Cummings SR (2009) The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS). Osteoporos Int 20(2):275–282CrossRefGoogle Scholar
  6. 6.
    Schnell S, Friedman SM, Mendelson DA, Bingham KW, Kates SL (2010) The 1-year mortality of patients treated in a hip fracture program for elders. Geriatr Orthop Surg Rehabil 1(1):6–14CrossRefGoogle Scholar
  7. 7.
    Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 22(3):465–475CrossRefGoogle Scholar
  8. 8.
    Yusuf AA, Matlon TJ, Grauer A, Barron R, Chandler D, Peng Y (2016) Utilization of osteoporosis medication after a fragility fracture among elderly Medicare beneficiaries. Arch Osteoporos 11(1):31CrossRefGoogle Scholar
  9. 9.
    Hajcsar EE, Hawker G, Bogoch ER (2000) Investigation and treatment of osteoporosis in patients with fragility fractures. CMAJ. 163(7):819–822PubMedPubMedCentralGoogle Scholar
  10. 10.
    Rodríguez PJA, Borzutzky SA, Barnett TC, Marín LPP (2003) Falta de reconocimiento de osteoporosis y omisión de tratamiento en adultos mayores con fractura de cadera en Chile. Rev Med Chil 131(7):773–778CrossRefGoogle Scholar
  11. 11.
    van den Bergh JP, van Geel TA, Geusens PP (2012) Osteoporosis, frailty and fracture: implications for case finding and therapy. Nat Rev Rheumatol 8(3):163–172CrossRefGoogle Scholar
  12. 12.
    Åkesson K, Marsh D, Mitchell PJ, McLellan AR, Stenmark J, Pierroz DD et al (2013) Capture the Fracture: a Best Practice Framework and global campaign to break the fragility fracture cycle. Osteoporos Int 24(8):2135–2152CrossRefGoogle Scholar
  13. 13.
    Giangregorio L, Thabane L, Cranney A, Adili A, deBeer J, Dolovich L, Adachi JD, Papaioannou A (2010) Osteoporosis knowledge among individuals with recent fragility fracture. Orthop Nurs 29(2):99–107CrossRefGoogle Scholar
  14. 14.
    Díaz-Correa LM, Ramírez-García LM, Castro-Santana LE, Vilá LM (2014) Osteoporosis knowledge in patients with a first fragility fracture in Puerto Rico. Bol Asoc Med P R 106(1):6–10PubMedGoogle Scholar
  15. 15.
    Johnell O, Kanis J (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(S02):S3–S7CrossRefGoogle Scholar
  16. 16.
    Sorbi R, Aghamirsalim MR (2012) Knowledge of orthopaedic surgeons in managing patients with fragility fracture. Int Orthop 36(6):1275–1279CrossRefGoogle Scholar
  17. 17.
    Kothawala P, Badamgarav E, Ryu S, Miller RM, Halbert RJ (2007) Systematic review and meta-analysis of real-world adherence to drug therapy for osteoporosis. Mayo Clin Proc 82(12):1493–1501CrossRefGoogle Scholar
  18. 18.
    Dell R (2011) Fracture prevention in Kaiser Permanente Southern California. Osteoporos Int 22(S3):457–460CrossRefGoogle Scholar
  19. 19.
    Aghamirsalim M, Mehrpour SR, Kamrani RS, Sorbi R (2012) Effectiveness of educational intervention on undermanagement of osteoporosis in fragility fractures. Arch Orthop Trauma Surg 132(10):1461–1465CrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2019

Authors and Affiliations

  • Daniel G. Fernández-Ávila
    • 1
    • 2
    Email author
  • Diana N. Rincón-Riaño
    • 3
  • Diego F. Pinzón
    • 4
  • Juan M. Gutiérrez Dávila
    • 1
  1. 1.Rheumatology Unit, Department of Internal Medicine, Hospital Universitario San Ignacio – School of MedicinePontificia Universidad JaverianaBogotáColombia
  2. 2.Unidad de Reumatología. Departamento Medicina InternaHospital Universitario San IgnacioBogotáColombia
  3. 3.Rheumatology Service, Hospital Militar Central – Universidad Militar Nueva GranadaBogotáColombia
  4. 4.Department of Internal Medicine, Hospital Universitario San Ignacio – School of MedicinePontificia Universidad JaverianaBogotáColombia

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