J Bone Metab.  2018 May;25(2):107-113. 10.11005/jbm.2018.25.2.107.

Improvement of Osteoporosis Medication after Multimodal Intervention in Patients with Hip Fracture: Prospective Multicenter Study

• Park YG
• Nam KW
• Kim SR
• Park MS
• Kim SJ
• Ha YC

• KMID: 2413372
• DOI: http://doi.org/10.11005/jbm.2018.25.2.107

Abstract

BACKGROUND
The authors had earlier conducted a retrospective cohort study from 2008 to 2011 in Jeju Island, among 945 hip fracture patients above 50 years of age. Of these 945 patients, 344 patients (36.4%) underwent a bone mineral density test and 218 patients (23.1%) received treatment for osteoporosis. The purpose of this study was to determine whether a patient education program could improve osteoporosis management after hip fracture. The data of the previous study was used for comparison.
METHODS
From November 1, 2014 to September 30, 2015, 190 patients above 50 years of age who were admitted for hip fractures at six different hospitals, were enrolled in the present study. During the hospitalization period, patients underwent education sessions and were provided brochures. Patients were evaluated for diagnosis and treatment of osteoporosis at six months after discharge and were followed-up for at least a year.
RESULTS
Of the 222 patients with hip fractures, 190 patients (37 men, 153 women) were enrolled at six hospitals in 2015. Dual energy X-ray absorptiometry was performed on 115 patients (60.5%) and 92 patients (48.4%) were prescribed medication for osteoporosis at the time of discharge. A total of 43.7% and 40.2% of the patients were found to be compliant with osteoporosis medication at 6 months and 12 months follow-up respectively.
CONCLUSIONS
This interventional multicenter study demonstrated that a patient education program in patients with hip fractures can improve compliance to osteoporosis medication up to 12 months of follow-up.

Keyword

Hip fractures; Osteoporosis; Patient education as topic; Therapeutics

MeSH Terms

Absorptiometry, Photon
Bone Density
Cohort Studies
Compliance
Diagnosis
Education
Follow-Up Studies
Hip Fractures
Hip*
Hospitalization
Humans
Male
Osteoporosis*
Pamphlets
Patient Education as Topic
Prospective Studies*
Retrospective Studies

Figure

• 

  Fig. 1 Flow of the cohort study. ICD-10, International Classification of Diseases, 10th revision.

Reference

1. Ha YC, Park YG, Nam KW, et al. Trend in hip fracture incidence and mortality in Korea: a prospective cohort study from 2002 to 2011. J Korean Med Sci. 2015; 30:483–488. PMID: 25829818.

2. Ha YC, Kim TY, Lee A, et al. Current trends and future projections of hip fracture in South Korea using nationwide claims data. Osteoporos Int. 2016; 27:2603–2609. PMID: 27112763.

3. Abrahamsen B, van Staa T, Ariely R, et al. Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int. 2009; 20:1633–1650. PMID: 19421703.

4. Choi HJ, Shin CS, Ha YC, et al. Burden of osteoporosis in adults in Korea: a national health insurance database study. J Bone Miner Metab. 2012; 30:54–58. PMID: 21633927.

5. Lee SR, Ha YC, Kang H, et al. Morbidity and mortality in Jeju residents over 50-years of age with hip fracture with mean 6-year follow-up: a prospective cohort study. J Korean Med Sci. 2013; 28:1089–1094. PMID: 23853495.

6. Lee YK, Ha YC, Yoon BH, et al. Incidence of second hip fracture and compliant use of bisphosphonate. Osteoporos Int. 2013; 24:2099–2104. PMID: 23247329.

7. Lee YK, Ha YC, Choi HJ, et al. Bisphosphonate use and subsequent hip fracture in South Korea. Osteoporos Int. 2013; 24:2887–2892. PMID: 23681088.

8. Lyles KW, Colón-Emeric CS, Magaziner JS, et al. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007; 357:1799–1809. PMID: 17878149.

9. Shibli-Rahhal A, Vaughan-Sarrazin MS, Richardson K, et al. Testing and treatment for osteoporosis following hip fracture in an integrated U.S. healthcare delivery system. Osteoporos Int. 2011; 22:2973–2980. PMID: 21271339.

10. Lai MM, Ang WM, McGuiness M, et al. Undertreatment of osteoporosis in regional Western Australia. Australas J Ageing. 2012; 31:110–114. PMID: 22676170.

11. Bogoch ER, Elliot-Gibson V, Beaton DE, et al. Effective initiation of osteoporosis diagnosis and treatment for patients with a fragility fracture in an orthopaedic environment. J Bone Joint Surg Am. 2006; 88:25–34.

12. Kim SR, Ha YC, Park YG, et al. Orthopedic surgeon's awareness can improve osteoporosis treatment following hip fracture: a prospective cohort study. J Korean Med Sci. 2011; 26:1501–1507. PMID: 22065908.

13. Kim SR, Park YG, Kang SY, et al. Undertreatment of osteoporosis following hip fractures in jeju cohort study. J Bone Metab. 2014; 21:263–268. PMID: 25489575.

14. Majumdar SR, Beaupre LA, Harley CH, et al. Use of a case manager to improve osteoporosis treatment after hip fracture: results of a randomized controlled trial. Arch Intern Med. 2007; 167:2110–2115. PMID: 17954806.

15. Miki RA, Oetgen ME, Kirk J, et al. Orthopaedic management improves the rate of early osteoporosis treatment after hip fracture. A randomized clinical trial. J Bone Joint Surg Am. 2008; 90:2346–2353. PMID: 18978403.

16. Morrish DW, Beaupre LA, Bell NR, et al. Facilitated bone mineral density testing versus hospital-based case management to improve osteoporosis treatment for hip fracture patients: additional results from a randomized trial. Arthritis Rheum. 2009; 61:209–215. PMID: 19177538.

17. Piziak VK, Rajab MH. An effective team approach to improve postoperative hip fracture care. J Orthop Trauma. 2011; 25:72–75. PMID: 21245708.

18. Kandel L, Schler D, Brezis M, et al. A simple intervention for improving the implementation rate of a recommended osteoporosis treatment after hip fracture. Endocr Pract. 2013; 19:46–50. PMID: 23186951.

19. Sjöberg C, Wallerstedt SM. Effects of medication reviews performed by a physician on treatment with fracture-preventing and fall-risk-increasing drugs in older adults with hip fracture-a randomized controlled study. J Am Geriatr Soc. 2013; 61:1464–1472. PMID: 24028354.

20. Gallagher AM, Rietbrock S, Olson M, et al. Fracture outcomes related to persistence and compliance with oral bisphosphonates. J Bone Miner Res. 2008; 23:1569–1575. PMID: 18505366.

21. Sale JE, Beaton D, Posen J, et al. Systematic review on interventions to improve osteoporosis investigation and treatment in fragility fracture patients. Osteoporos Int. 2011; 22:2067–2082. PMID: 21607808.

22. Eisman JA, Bogoch ER, Dell R, et al. Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res. 2012; 27:2039–2046. PMID: 22836222.

23. Ganda K, Puech M, Chen JS, et al. Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int. 2013; 24:393–406. PMID: 22829395.

24. Bogoch ER, Elliot-Gibson V, Beaton D, et al. Fracture prevention in the orthopaedic environment: outcomes of a coordinator-based fracture liaison service. J Bone Joint Surg Am. 2017; 99:820–831. PMID: 28509822.