Gap in Care Found for Fracture Patients

Main Category: Nutrition / Diet
Article Date: 15 Oct 2004 - 0:00 PDT

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In a recent one-year study following the care of patients over the age of 51 who had been seen at a hospital for an acute fracture, researchers at Tufts and other institutions found that few of these patients were treated for osteoporosis. The authors note that the risk of re-fracture could be reduced drastically if more patients were evaluated and treated for osteoporosis.

In the study, six months after the fracture, of the 86 patients who could be reached, only 36% of the women and 7% of the men had recently discussed osteoporosis with their primary care physician, and there was no increase in the use of osteoporosis medications by the patients. Among the men and women who were advised by their doctors to increase intake of vitamin D and calcium, there was a significant increase in the use of vitamin D and calcium supplements, and an increase in the consumption of dairy foods. But, importantly, the men and women who did not receive this advice showed no significant changes in their intake of these substances. At twelve months, the treatment profiles were unchanged.

"Our study shows that when doctors do recommend increasing vitamin D and calcium, that patients comply," said corresponding author Bess Dawson-Hughes, MD, director of the Bone Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts. "Primary care physicians are in a position to help patients reduce their risk of re-fracture by taking prescription osteoporosis medication and by increasing vitamin D and calcium in their diets. These patients just need a bit of counsel."

"In conclusion, the occurrence of a fracture did not prompt additional prescription bone medication use in either the women or the men in this study. Men were not advised to increase their calcium intakes after their fractures and did not do so. Calcium supplement use and dairy food intake did increase after the fractures in the women, and these increases occurred specifically in those women who were advised by their physicians to consume more calcium. The responsiveness of our patients to the advice of their physicians suggests that the primary care physician is well positioned to bring about much needed change in the care of fracture patients," reported Bess Dawson-Hughes and co-authors in the conclusion of the study.

For "Fast Facts" about the prevalence of osteoporosis, please visit the National Osteoporosis Foundation web site at: http://www.nof.org/osteoporosis/diseasefacts.htm

*Pro-Risquez, A., Harris, S., Song, L., Rudicel, S., Barnewolt, B., Dawson-Hughes, B. Osteoporosis International, 2004, 15: 689-694. "Calcium supplement and osteoporosis medication use in women and men with recent fractures."

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Contact: Siobhan Gallagher
siobhan.gallagher@tufts.edu
617-636-6586
Tufts University

If you are interested in hearing more about any of the studies or speaking with a member of the faculty of the Friedman School of Nutrition Science and Policy or another Tufts health sciences researcher, please contact Siobhan Gallagher via email at Siobhan.Gallagher@tufts.edu or by calling 617-636-6586.
The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school's eight centers, which focus on questions relating to famine, hunger, poverty, and communications, are renowned for the application of scientific research to national and international policy. For two decades, the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University has studied the relationship between good nutrition and good health in aging populations. Tufts research scientists work with federal agencies to establish the USDA Dietary Guidelines, the Dietary Reference Intakes, and other significant public policies.

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