Follow-up treatment for osteoporosis after fracture
Follow-up treatment for osteoporosis after fracture
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DOI：
10.1007/s00198-004-1676-4
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发表时间：
2005-03-01
影响因子：
4
通讯作者：
Benjamin, E
中科院分区：
文献类型：
--
作者：
Hooven, F;Gehlbach, SH;Benjamin, E
对髋部或手腕骨折的老年妇女骨质疏松症的管理研究发现，对这种疾病的诊断和治疗不足。然而，在美国进行的此类研究很少，大多数研究仅限于目前可用于治疗骨质疏松症的治疗方法的一个子集。1998年10月1日至2000年9月30日期间，我们向381名50至84岁之间的女性发送了邮件调查，这些女性曾在美国东北部一家大型教学医院接受髋部或手腕骨折治疗。这些调查包括关于骨质疏松症危险因素和指数骨折前后医生治疗的问题。在邮寄的381份调查中，有70份是因为地址无效或因为病人去世而被亲戚退回的。在其余的311项调查中，共收到147份完整的答复。52%的受访者报告说，在骨折前接受过用于治疗骨质疏松症的非处方药的处方或建议。骨折后，60%的受试者被建议服用任何骨质疏松症药物，42%的受试者被建议服用处方药。在报告骨折前没有治疗建议的女性中，33%的人报告骨折后接受了治疗。24%的患者报告骨折后治疗与骨折前相比发生了变化。根据骨折史、母亲骨折史或母亲骨质疏松症史，治疗无显著差异。骨折后处方和非处方治疗的患病率均低于预期，骨折后报告的治疗患病率与骨折前相比只有很小的变化。基于骨质疏松症或骨质疏松性骨折的危险因素，治疗流行率也几乎没有差异。对于有骨折史的患者，存在相当大的干预机会，以降低骨质疏松性骨折的风险。
Studies of the management of osteoporosis in older women who have had hip or wrist fractures have found underdiagnosis and undertreatment of the disease. Few such studies have been conducted in the United States, however, and most studies have been confined to a subset of the treatments currently available to treat osteoporosis. Mail surveys were sent to 381 women between 50 and 84 years of age who had been treated for a hip or wrist fracture at a large northeast US teaching hospital between October 1, 1998, and September 30, 2000. These surveys included questions about osteoporosis risk factors and physician treatment both before and after the index fracture. Of 381 surveys mailed, 70 were returned because of an invalid address or by a relative because a patient was deceased. Of the remaining 311 surveys, 147 completed responses were received. Fifty-two percent of respondents reported having received either a prescription or a recommendation for a nonprescription medication used to treat osteoporosis before the fracture. After fracture, 60% of subjects were advised to take any osteoporosis medication, and 42% of were advised to take a prescription medication. Of women reporting no treatment advice before fracture, 33% reported treatment after. Twenty-four percent of patients reported a change in treatment after fracture versus before. No significant differences in treatment were found according to fracture history, maternal history of fracture, or maternal history of osteoporosis. Both prescription and nonprescription treatment prevalence after fracture were lower than expected, and there was only a small change in reported treatment prevalence after fracture versus before. There was also little difference in treatment prevalence based on risk factors for osteoporosis or osteoporotic fractures. A sizeable opportunity exists for intervention to reduce the risk of osteoporotic fractures for patients who have a history of fracture.