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Keywords:

  • fracture;
  • osteoporosis;
  • osteoporosis awareness;
  • osteoporosis investigation;
  • osteoporosis treatment

Abstract

Background: Patients with fragility fractures secondary to osteoporosis are at risk of recurrent fracture. Osteoporosis is often underrecognized and undertreated. We looked at the levels of awareness, investigation and treatment of patients with fracture.

Methods: The study group included patients admitted to a tertiary teaching hospital. Postal surveys were sent to female patients over 60 years of age who had been identified in the hospital database as having International Classification of Diseases-10 codes for fracture and discharged between June 1997 and January 2002. The questionnaire had specific questions on the histories of the fractures, the risk factors, the awareness of osteoporosis, bone mineral density testing and the treatment for osteoporosis.

Results: Of 1584 surveys posted, 366 valid questionnaires were returned. The median age of respondents was 81 years with a range of 60–99 years. Fifty-nine per cent reported one fracture, 41% two or more fractures and 65% reported a hip fracture. Forty-eight per cent of patients were aware that they had osteoporosis and 35% reported having a bone density performed. Thirty-seven per cent reported being on treatment for osteoporosis on discharge, with the majority being on treatment with calcium (34%).

Conclusion: This postal survey of a high-risk patient group discharged from a tertiary hospital confirm the findings from other population-based and hospital-based studies that a significant proportion of patients at risk of further fracture are not investigated or offered specific treatment for osteoporosis. Lack of awareness of underlying osteoporosis by both treating clinicians and patients is likely to be a major contributing factor.