High prevalence of missed opportunities for secondary fracture prevention in a regional general hospital setting in Singapore
Summary This study aims at assessing the gap in secondary fracture prevention at a regional general hospital setting in Singapore. Male patients have significantly lower rate of being investigated and treated for osteoporosis than their female counterparts. Vitamin D deficiency is prevalent in our p...
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Published in | Archives of osteoporosis Vol. 12; no. 1; p. 60 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
London
Springer London
01.12.2017
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Subjects | |
Online Access | Get full text |
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Summary: | Summary
This study aims at assessing the gap in secondary fracture prevention at a regional general hospital setting in Singapore. Male patients have significantly lower rate of being investigated and treated for osteoporosis than their female counterparts. Vitamin D deficiency is prevalent in our population.
Purpose
Secondary fracture prevention services are not routine in Singapore; we seek to assess the treatment gap that exists in the lack of diagnosis and treatment of osteoporosis in fragility fracture patients.
Methods
We performed a retrospective analysis of all admissions for fragility fractures between December 2013 and December 2014. Demographic data, rates of BMD performance, serum vitamin D investigation and calcium and vitamin D supplementation as well as antiresorptive initiation 1 year post admission were analysed.
Results
There were 125 fragility fractures in patients below 65 and 615 fractures in older patients. There was a slightly higher proportion of males in the younger population, whereas females predominated in the older population. Median vitamin D levels were low in both younger (19.1 μg/L) and older (22.0 μg/L) groups, but supplementation was lower in younger patients (4.8 versus 16.6%,
p
= 0.003). Rate of BMD performance was lower in younger patients (34.4 versus 64.6%,
p
< 0.01); there was a significant difference of BMD performance between male and female patients in the younger population (19.1 versus 52.8%,
p
< 0.01) which was not present in the older age group. Antiresportive initiation was significantly lower in the younger age group versus older (10.4 versus 31.5%,
p
< 0.01); male patients in the younger and older age groups had significantly lower antiresorptive initiation rate compared to the females.
Conclusion
There is a significant treatment gap in diagnosis and treatment of osteoporosis in fragility fracture patients in a regional hospital setting in Singapore. Male osteoporosis remains inadequately investigated and treated in both age groups
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 1862-3522 1862-3514 |
DOI: | 10.1007/s11657-017-0356-x |