31 - Freie Mitteilung
15. Mai 2019, 15:30 - 17:00, Szenario 1, 5. OG
Secondary prevention of minor trauma fractures: The effects of a tailored intervention – An observational study
P. C. van der Vet, J. Q. Kusen, M. Rohner-Spengler, B. C. Link, R. Babst, L. Schmid, C. Henzen, F. J. Beeres, Presenter: M. Rohner-Spengler (Lucerne)
Minor Trauma Fractures (MTF) in the elderly are common and impose a burden on public health. MTF patients often have an underlying bone disease, mostly osteoporosis. Osteoporosis is known to be underdiagnosed and undertreated. Efficient treatment of osteoporosis can reduce fracture risk. An intervention to foster screening and treatment of osteoporosis, aimed at reducing the risk of subsequent fracture, was implemented . The primary aim of this study was to assess the efficacy of the implemented intervention in improving osteoporosis screening and treatment, thereby preventing subsequent fractures after an initial MTF.
Prospective, single-centre, cohort study of MTF patients of 50 years or older. A standardized questionnaire and telephone interview were used to collect one-year follow-up data. The primary outcome was the rate of patients undergoing Dual X-ray Absorptiometry (DXA) scanning. Secondary outcomes were: the rate of patients with a diagnosis of osteoporosis or osteopenia, the rate of patients treated with anti-osteoporotic medication and the rate of patients with a subsequent fracture. DXA rate, the prevalence of a diagnosis (osteoporosis/osteopenia) and data on medical treatment were compared to the results of a previous study in the same hospital.
A total of 411 patients were included (mean age: 72±9.3 years). 63.3% of the patients received a DXA scan, compared to 12.6% reported in our previous study. Of all patients who received a DXA scan, 82.9% were diagnosed with osteoporosis or osteopenia. Of the patients who had a DXA proved diagnosis of osteoporosis, 57.1% received specific and 90.8% received unspecific treatment for osteoporosis. Fifteen patients (3.9%) had a subsequent fracture as a result of a minor trauma fall.
The implementation of a MTF secondary prevention program with dedicated health professionals improved the rate of patients who underwent DXA screening by 5-fold. Despite this improvement, DXA screening was missed in over a third of the patients. Furthermore, there is still a lack of patients being treated with specific osteoporosis medication. Consequently, this tailored intervention is a promising first step in improving geriatric fracture care. However, further work to improve the rate of osteoporosis screening and treatment for the long-term prevention of subsequent MTF is recommended.