QUEBEC CITY — Women who have had a low-trauma fracture are not getting the follow-up they need for osteoporosis, Sonia Singh, M.D., reported in a poster at the annual meeting of the North American Primary Care Research Group.
History of a previous low-trauma fracture is associated with a 40% increased risk of hip fracture, Dr. Singh reported.
A retrospective chart review identified 100 women aged 40 years or older who presented with a low-trauma fracture to a community hospital emergency department.
A questionnaire was sent to the women 6–9 months after the fracture to determine if they had been given a diagnosis of osteoporosis or had received any treatment, even just calcium supplementation.
Preliminary results from 42 women showed that 22 (52%) had no follow-up, 12 (29%) had received an ultrasound or bone mineral density scan, and 8 (19%) had follow-up without testing.
Of the 20 patients with follow-up, 7 (35%) had been prescribed medications.
Interviews with the women revealed that only 7 (17%) thought they were at an increased risk for another fracture.
Surprisingly, having had two or three previous fractures did little to change that perception or to improve medication rates, said Dr. Singh, clinical research associate, Peace Arch Hospital, White Rock, B.C., Canada.
A previous study found similar follow-up and treatment rates, with fewer than 20% of 108 men and women who presented with fragility-type fractures at three Ontario hospitals receiving follow-up 1 year later (CMAJ 2000;163:819–22).
“Despite the fact there has been a heightened profile for osteoporosis, that in itself has not improved the management,” she said. “Our follow-up and treatment [findings] were a little better than the previous studies, but it's still not acceptable.”