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Prescription of anti-osteoporosis medications after hospitalization for hip fracture: a multicentre Italian survey

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Abstract

Purpose

Literature data indicate that the proportion of patients with recent hip fracture who receive a prescription for anti-osteoporotic drugs is low and does not seem to increase over time. This study aimed to obtain data on the prescription for anti-osteoporotic drugs in Italian patients discharged after a recent hip fracture and to assess which variables could have influenced the decision for prescribing osteoporosis medication.

Methods

A total of four Italian centres located in four different geographical areas (Siena, Verona, Naples and Palermo) participated in this retrospective study. In each centre, experienced clinicians gathered the data of up to 200 consecutive patients discharged after a recent low-trauma hip fracture. The analysis was carried out on 697 patients (540 women and 157 men; mean age 81.9 ± 8.6 years).

Results

The percentage of patients who were receiving any type of treatment for osteoporosis before the hip fracture was 8.8% (ranging from 2.4% in Naples to 17.4% in Verona). After the index hip fracture, only 23.2% of patients (namely 10.5% of men and 27.2% of women) received prescription for any pharmacological treatments for osteoporosis. Both female gender and previous use of medications for osteoporosis were positively associated with the likelihood of receiving prescription for anti-osteoporotic treatment at discharge.

Conclusions

This study showed that less than 25% of the elderly Italian patients discharged after a hip fracture received a prescription for any type of treatment for osteoporosis and highlights the urgent need for implementing new strategies in the management of hip fracture patients.

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References

  1. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733

    Article  CAS  Google Scholar 

  2. Cooper C, Cole ZA, Holroyd CR et al (2011) Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int 22:1277–1288

    Article  CAS  Google Scholar 

  3. McClung MR (2003) Pathogenesis of osteoporotic hip fractures. Clin Cornerstone 2:S22–S29

    Article  Google Scholar 

  4. Piscitelli P, Iolascon G, Argentiero A et al (2012) Incidence and costs of hip fractures vs strokes and acute myocardial infarction in Italy: comparative analysis based on national hospitalization records. Clin Interv Aging 7:575–583

    Article  Google Scholar 

  5. Klotzbuecher CM, Ross PD, Landsman PB et al (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739

    Article  CAS  Google Scholar 

  6. Center JR, Bliuc D, Nguyen TV et al (2007) Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 297:387–394

    Article  CAS  Google Scholar 

  7. Slemenda C (1997) Prevention of hip fractures: risk factor modification. Am J Med 18:65S–71S

    Article  Google Scholar 

  8. Rabenda V, Vanoverloop J, Fabri V et al (2008) Low incidence of anti-osteoporosis treatment after hip fracture. J Bone Joint Surg Am 90:2142–2148

    Article  Google Scholar 

  9. Brozek W, Reichardt B, Zwerina J et al (2016) Antiresorptive therapy and risk of mortality and refracture in osteoporosis-related hip fracture: a nationwide study. Osteoporos Int 27:387–396

    Article  CAS  Google Scholar 

  10. Rossini M, Adami S, Bertoldo F et al (2016) Guidelines for the diagnosis, prevention and management of osteoporosis. Reumatismo 23:1–39

    Article  Google Scholar 

  11. National Osteoporosis Foundation (2013) Clinician’s guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington

    Google Scholar 

  12. Cree MW, Juby AG, Carriere KC (2003) Mortality and morbidity associated with osteoporosis drug treatment following hip fracture. Osteoporos Int 14:722–727

    Article  Google Scholar 

  13. Lyles KW, Colón-Emeric CS, Magaziner JS et al (2011) Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med 357:1799–1809

    Article  Google Scholar 

  14. Nurmi-Luthje I, Sund R, Juntunen M et al (2011) Post-hip fracture use of prescribed calcium plus vitamin D or vitamin D supplements and antiosteoporotic drugs is associated with lower mortality: a nationwide study in Finland. J Bone Miner Res 26:1845–1853

    Article  CAS  Google Scholar 

  15. Kim SC, Kim MS, Sanfélix-Gimeno G et al (2015) Use of osteoporosis medications after hospitalization for hip fracture: a cross-national study. Am J Med 128:519–526

    Article  Google Scholar 

  16. Gardner MJ, Flik KR, Mooar P et al (2002) Improvement in the undertreatment of osteoporosis following hip fracture. J Bone Joint Surg Am 84:1342–1348

    Article  Google Scholar 

  17. Panneman MJ, Lips P, Sen SS et al (2004) Undertreatment with anti-osteoporotic drugs after hospitalization for fracture. Osteoporos Int 15:120–124

    Article  Google Scholar 

  18. Solomon DH, Diem SJ, Ruppert K et al (2015) Bone mineral density changes among women initiating proton pump inhibitors or H2 receptor antagonists: a SWAN cohort study. J Bone Miner Res 30:232–239

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  20. Carnevale V, Nieddu L, Romagnoli E et al (2006) Osteoporosis intervention in ambulatory patients with previous hip fracture: a multicentric, nationwide Italian survey. Osteoporos Int 17:478–483

    Article  Google Scholar 

  21. Rossini M, Viapiana O, Adami S et al (2014) Medication use before and after hip fracture: a population-based cohort and case-control study. Drugs Aging 31:547–553

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  23. Ruggiero C, Zampi E, Rinonapoli G et al (2015) Fracture prevention service to bridge the osteoporosis care gap. Clin Interv Aging 10:1035–1042

    PubMed  PubMed Central  Google Scholar 

  24. Giannini S, Sella S, Rossini M et al (2016) Declining trends in the incidence of hip fractures in people aged 65 years or over in years 2000–2011. Eur J Intern Med. doi:10.1016/j.ejim.2016.06.007

    Article  PubMed  Google Scholar 

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

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy

    Stefano Gonnelli, Carla Caffarelli, Aurora Patti & Ranuccio Nuti

  2. Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy

    Giovanni Iolascon

  3. Department of Medicine, and Department of Neurological Sciences and Movement, University of Verona, Verona, Italy

    Francesco Bertoldo

  4. Department of Surgical and Oncology Sciences, University of Palermo, Palermo, Italy

    Giulia Letizia Mauro

Authors
  1. Stefano Gonnelli
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  2. Carla Caffarelli
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  3. Giovanni Iolascon
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  4. Francesco Bertoldo
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  5. Giulia Letizia Mauro
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  6. Aurora Patti
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  7. Ranuccio Nuti
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Corresponding author

Correspondence to Stefano Gonnelli.

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Conflict of interest

Stefano Gonnelli, Carla Caffarelli, Giovanni Iolascon, Francesco Bertoldo, Giulia Letizia Mauro, Aurora Patti and Ranuccio Nuti declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration. Procedures performed in this study did not involve animals.

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Gonnelli, S., Caffarelli, C., Iolascon, G. et al. Prescription of anti-osteoporosis medications after hospitalization for hip fracture: a multicentre Italian survey. Aging Clin Exp Res 29, 1031–1037 (2017). https://doi.org/10.1007/s40520-016-0681-8

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  • DOI: https://doi.org/10.1007/s40520-016-0681-8

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