3-year follow-up of 215 fracture patients from a prospective and consecutive osteoporosis screening program
3-year follow-up of 215 fracture patients from a prospective and consecutive osteoporosis screening program
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DOI：
10.1080/17453670710015328
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发表时间：
2008-01-01
影响因子：
3.7
通讯作者：
Akesson, Kristina
中科院分区：
文献类型：
--
作者：
Astrand, Jorgen;Thorngren, Karl-Goran;Akesson, Kristina
背景和目的如果发现并治疗骨质疏松症，骨折是可以预防的。从2002年开始，我们一直在使用一项筛查计划，对50至75岁的腕部、肩部、脊椎或髋部骨折的患者进行髋关节和脊柱的DEXA检查，如果患有骨质疏松症或骨质疏松，鼓励他们去看自己选择的医生。患者会收到包含信息、DEXA结果的文件，以及一封提交给医生的关于血液测试和治疗的建议的信。在这里，我们报告了关于推荐治疗依从性的3年随访。方法从2002年11月到2003年11月，向参加初步筛查研究的骨折患者发出问卷。调查内容包括是否看过医生、是否开始治疗以及对骨质疏松的看法。结果236名患者中有215人回答了问卷调查，平均随访时间为39个月。骨质疏松症患者中76/87、骨质疏松症患者中70/99、骨密度正常者中11/29曾就诊。三分之二的骨质疏松症患者，六分之一的骨量减少患者，没有一名骨密度正常的患者接受了抗吸收治疗。1/3的骨质疏松症患者、一半的骨质疏松患者和一半的正常患者接受了钙-维生素D的单一治疗。只有少数骨质疏松症患者、三分之一的骨质疏松患者和一半的正常患者没有接受治疗。在接受治疗的患者中，治疗依从性在3年内达到80%。对骨折患者进行骨质疏松释义筛查，能有效识别骨密度低的患者，可信赖患者寻求适当的医疗建议来治疗骨质疏松症。根据骨扫描诊断，这些患者所接受的治疗很好地反映了当前的治疗指南。
Background and purpose Fractures can be prevented if osteoporosis is identified and treated. Starting in 2002, we have been using a screening program in which patients between 50 and 75 years of age with a wrist, shoulder, vertebral, or hip fracture are assessed by DEXA of the hip and spine and if osteoporostic or osteopenic, they are encouraged to see a doctor of their own choice. The patients receive documents containing information, the results of DEXA, and a letter to present to their doctor with suggestions regarding blood tests and treatment. Here we report the 3-year follow-up regarding compliance to the recommended treatment.Methods A questionnaire was sent to fracture patients who participated in the initial screening study from November 2002 through November 2003. Questions included whether they had seen a doctor, whether treatment had been initiated, and their opinions about osteoporosis.Results 215 of the 236 patients answered the questionnaire, with a mean follow-up of 39 months. 76/87 of those with osteoporosis, 70/99 of those with osteo-penia, and 11/29 of those with normal BMD had seen a doctor. Anti-resorptive treatment was prescribed to two-thirds of the osteoporotic patients, to one-sixth of the osteopenic patients, and to none of the patients with normal bone density. Calcium-vitaminD supplementation as monotherapy was given to one-third of the osteoporotic patients, to half of the osteopenic patients, and to half of the normal patients. Only a few osteoporotic patients, one-third of the osteopenic patients, and half of the normal patients received no treatment. Compliance to treatment was 80% over 3 years in those treated. Most patients felt that they could influence their skeletal health.Interpretation Screening of fracture patients for osteoporosis effectively identifies patients with low bone mineral density and the patient can be trusted to seek appropriate medical advice for treatment of osteoporosis. Based on the bone scan diagnosis, the treatment that these patients received reflects current treatment guidelines well.