At-risk elderly under-treated for osteoporosis

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Less than three percent of elderly patients who experience hip fractures go home with prescriptions for all of the medications needed to treat osteoporosis, according to new study findings reported today.

Most elderly patients who experience hip fractures have osteoporosis, making this low rate of treatment “appalling,” study author Dr. Kurt Cullamar told Reuters Health.

And if elderly patients’ relatively weak bones succumbed to a fracture once, they can do it again, he noted. “All steps should be taken to strengthen the bones and prevent another hip fracture,” he said.

According to the National Institutes of Health, more than 9 out of 10 hip fractures are linked to osteoporosis. Furthermore, research shows that people who have had at least one hip fracture are 17 to 21 percent more likely to have another fracture within the following two years.

Calcium and vitamin D supplementation, as well as the newer bisphosphonate drugs, are known to effectively treat osteoporosis, thereby reducing the likelihood of hip fractures in high-risk patients. Yet, various studies have shown many doctors are not prescribing these treatments to their patients.

Currently, the National Osteoporosis Foundation (NOF) recommends that elderly patients who experience a fracture due to fragile bones take vitamin D, calcium and a bisphosphonate.

As part of the current study, Cullamar and his colleagues followed 115 patients over the age of 52 who experienced hip fractures, noting which prescriptions they received before being discharged from a short-term rehabilitation facility.

The investigators found that less than three percent of discharged patients received all three medications recommended by the NOF. Around 30 percent of participants received some of the medications, and more than 67 percent were given no prescriptions for osteoporosis medications.

The researchers presented their findings during the annual meeting of the American Geriatrics Society in Las Vegas.

In an interview, Cullamar, who is based at Maimonides Medical Center in Brooklyn, New York, explained that hip fracture patients are also at high risk of potentially deadly blood clots, a condition known as deep vein thrombosis (DVT).

More than 60 percent of participants received treatment to prevent DVT, suggesting that their doctors were more focused on that risk than on treating osteoporosis, Cullamar explained. “People are more worried about DVT,” he said.

He added that he hopes these findings help inspire more education about the importance of treating osteoporosis for doctors in facilities that treat hip fracture patients, so that they don’t have to see the same patients twice.

“You want the patients to have stronger bones to prevent another fracture happening,” he said.

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