A study by IDIAPJGol recommends improving follow-up in primary care for elderly people who suffer fractures
Researchers call for early diagnosis, better treatment, and more control over the recovery of patients who have suffered a fragility fracture
A study coordinated by IDIAPJGol researcher Daniel Martínez Laguna has identified deficiencies in the treatment and follow-up in primary care of elderly people who suffer fragility fractures. The work, published in the journal Archives of Osteoporosis, concludes that it is necessary to improve the follow-up of the recovery from these fractures, which in many cases are not monitored after the initial post-fracture care.
In its conclusions, the study highlights the urgent need to improve the prevention of fragility fractures among the elderly through primary care. For this reason, it recommends early diagnosis, assessing the risk of elderly people suffering fractures, and improving the management of treatment, adherence, and follow-up for people with osteoporosis, especially those with more risk factors, such as having suffered multiple fractures.
Lack of follow-up
The study's results show that patients with one fracture have a lower treatment rate compared to those who have suffered multiple fractures. Only 18% of people started treatment within 90 days after a first fracture, while this figure drops to 12% and 13% after a second and third fracture, respectively.
According to the research, among patients with a second fracture, more than a quarter continued previous osteoporosis treatment at the time of their second fracture, and among those with a third fracture, nearly half continued previous osteoporosis treatment at the time of the third break.
Overall, women are more likely than men to receive treatment for the fracture or to continue previous osteoporosis treatment after their first fragility fracture. Up to a quarter of patients did not have any follow-up visit after the injury.
One of the main causes of comorbidity
Fragility fractures are the fourth leading cause of comorbidity of chronic diseases in Europe. Only ischemic heart disease, dementia, and lung cancer rank higher. According to the International Osteoporosis Foundation, the annual incidence of fragility fractures in the five largest countries of the European Union plus Sweden will increase by 23% between 2017 and 2030, from 2.7 million to 3.3 million. Additionally, it is estimated that the total costs associated with fragility fractures in the European Union were 29.6 billion euros in 2010 and are expected to increase by approximately 54% by 2030.
More than 60% of the people who participated in the study and who had suffered a fragility fracture had received osteoporosis treatment before the fracture, and about three-quarters were taking calcium and vitamin D supplements.
Reference to the article
Martínez-Laguna D, Carbonell Abella C, Bastida JC, González M, Micó-Pérez RM, Vargas F, Díaz Torres E, Canals L; PREFRAOS Group. Secondary fracture prevention in Spanish primary care: results of the PREFRAOS Study. Arch Osteoporos. 2024 May 9;19(1):35. doi: 10.1007/s11657-024-01394-3. PMID: 38722400; PMCID: PMC11081989.
https://pubmed.ncbi.nlm.nih.gov/38722400/
