VIRTUAL ORTHOPEDIC-REHABILITATION-METABOLIC COLLABORATION FOR TREATING OSTEOPOROTIC HIP FRACTURES.
VIRTUAL ORTHOPEDIC-REHABILITATION-METABOLIC COLLABORATION FOR TREATING OSTEOPOROTIC HIP FRACTURES.
复制标题
用于治疗骨质疏松性髋部骨折的虚拟骨科-康复-代谢协作。
作者：
Osnat Tell Lebanon;D. Netzer;E. Yaacobi;Y. Berner;D. Spiegel;Rakefet Bacharach;D. Nabriski;M. Nyska;Y. Brin;P. Rotman
Objective: Evaluate the effectiveness of a virtual, closed-loop protocol that treated hip fracture patients without formal clinic visits. Method: In this prospective cohort study, an intervention group of 85 hip fracture patients (33.6%) with vitamin D levels ≥65nmol/l, who received recommendations for osteoporosis treatment was compared to a non-intervention group of 168 (66.4%), with vitamin D <65nmol/l. Treatment included Vitamin D loading in Orthopedic and Rehabilitation Departments for patients from both groups, and virtual, osteoporosis treatment recommendations by Metabolic Clinic Physicians to patients from the intervention group upon achieving vitamin D level ≥65nmol/l. Recommendations were given without requiring clinic visits. Osteoporosis drug recommendations were relayed to PCPs. Primary endpoint was patients receiving osteoporosis drugs within 12-months post-surgery. Secondary endpoints were patients issued drugs within 3- and 6-months post-surgery, and one-year post-fracture mortality rates. Results: Among 253 hip fracture patients (81.3±10.7 years-of-age, 68.8% women), post-intervention, osteoporosis medication issue rate was higher than in the non-intervention group (48.2% vs. 22.0%, respectively; p<0.001). More intervention group patients received drugs 3 months (18.8% vs. 2.9%, p<0.001) and 6 months after surgery (40% vs. 5.9%, p<0.001). One-year mortality was lower among patients who received any osteoporosis medications (either through our intervention or from community physicians) than among untreated patients (5.1% vs. 26.3%, p<0.001). Conclusion: Virtual Orthopedic-Rehabilitation-Metabolic collaboration increased osteoporosis treatment rates post-hip fracture. Yet, treatment rates remained <50%. Additional research is required to increase treatment rates further, such as providing drug therapy shortly after surgery, perhaps during rehabilitation or lowering the vitamin D threshold.
影响因子：
158.5
作者：
Lyles, Kenneth W.;Colon-Emeric, Cathleen S.;Boonen, Steven
通讯作者：
Boonen, Steven
影响因子：
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作者：
Berry, Sarah D.;Samelson, Elizabeth J.;Kiel, Douglas P.
通讯作者：
Kiel, Douglas P.