Dr. Harrington has received consultant fees and speaker honoraria (less than $10,000) from The Alliance for Better Bone Health, and is the inventor of the Stop Osteoporosis task management software (copyrighted by the Wisconsin Alumni Research Foundation).
Osteoporosis disease management for fragility fracture patients: New understandings based on three years' experience with an osteoporosis care service
Article first published online: 29 NOV 2007
Copyright © 2007 by the American College of Rheumatology
Arthritis Care & Research
Volume 57, Issue 8, pages 1502–1506, 15 December 2007
How to Cite
Harrington, J. T. and Lease, J. (2007), Osteoporosis disease management for fragility fracture patients: New understandings based on three years' experience with an osteoporosis care service. Arthritis & Rheumatism, 57: 1502–1506. doi: 10.1002/art.23093
- Issue published online: 29 NOV 2007
- Article first published online: 29 NOV 2007
- Manuscript Accepted: 15 MAY 2007
- Manuscript Received: 8 FEB 2007
- Alliance for Better Bone Health (Procter & Gamble and Sanofi-Aventis Pharmaceuticals) has provided grant support to the University of Wisconsin
- Clinical process improvement
To review the 3-year performance of an established osteoporosis care service and consider further improvements in an effort to reduce fragility fractures.
Osteoporosis care has been coordinated for all willing and able patients with orthopedic fragility fractures in our health system by a nurse and medical director since 2003, using a guideline-based care algorithm and task management software. Patients were followed by telephone for 2 years to monitor their status and optimize adherence to treatment. Demographics, management recommendations, clinical data, and adherence to treatment were reviewed for the 2003–2005 patient population.
Of 1,019 patients with fragility fractures, 61% underwent osteoporosis evaluation and treatment. The remainder included 15% who refused to participate and 24% who were unable to participate for various logistical and health reasons. More patients age >80 years were unwilling or unable to participate. Bone densities (dual x-ray absorptiometry [DXA]) were normal, low, or osteoporotic in 24%, 55%, and 21% of patients, respectively, and 60% of the osteoporotic group had ≥1 abnormal metabolic bone laboratory result. Only 17% of the total reported a previous fracture, and 47% had ever undergone DXA. Few experienced bone loss, a new fracture, or bisphosphonate intolerance during treatment.
An osteoporosis care service has coordinated care for every willing and able fragility fracture patient with positive outcomes. In addition, the results suggest a high priority for earlier proactive diagnosis and intervention of the at-risk population if fractures are to be reduced.