Notifications Improve Osteoporosis Care

Preventing osteoporosis fractures

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) You've just gotten out of the hospital after a major fracture. You want to avoid the experience again, but are you receiving care to prevent another fracture?

Osteoporosis patients who have had a major fracture at a high risk of repeated fractures. But after a break, there's no system for post-fracture care.

In a new study, researchers tested out mailing a notification about the patient's fracture and suggestions for follow-up care, and found that just a piece of mail can help prevent future breaks.

"After a fracture, ask your physician about follow up care."

In Canada, where the study was conducted, a 2010 report on osteoporosis clinical guidelines identified a large “care gap” for people who have had fractures due to fragile bones.

They found that most people who have had a major fracture do not undergo testing for bone mineral density, a standard practice for osteoporosis, nor do they receive medication for their condition.

Dr. William Leslie of the University of Manitoba wanted to find a way to close the gap between fractures and preventative care. He and his team of researchers created a simple notification system that would educate physicians and patients about how to best manage their follow-up care.

The study involved over 4,000 men and women over the age of 50 who had recently reported a major fracture, and divided them into three groups.

The first group was the control, receiving usual care, or no notifications. The second group had letters mailed to their primary care physicians, notifying them of their patient's fracture, and suggesting follow-up to assess osteoporosis.

The third group had these notifications sent to both the physician and the patient.

What the researchers wanted to find out was how many patients from each group received follow-up treatment with bone density testing and starting treatment with drugs, within 12 months of the notification.

They found that in the first group, 15.8 percent of women and 7.6 percent of men had follow up care. The other groups both had much higher rates of post-fracture care. The second group had 30.3 percent of women and 19 percent of men receive care, with the third group being slightly but not significantly higher.

In the study, the authors state that because the groups receiving notifications had better outcomes than usual care, the strategy could be adapted for every patient who has a major fracture.

They said that this would be a much easier and more cost-effective strategy than individual case-management.

But they concluded that their notification system is not the be-all-end-all for post-fracture care. They said that additional strategies should be developed and may prove to be even more effective at enhancing follow-up care.

If an effective strategy is adopted by clinical guidelines, that could translate into a reduction of repeat fractures.

The study was published in December 2011 in the journal CMAJ (Canadian Medical Association Journal).

Reviewed by: 
Review Date: 
December 20, 2011
Last Updated:
December 20, 2011