Adherence to therapeutic and diagnostic recommendations in patients with femur fracture and at risk of re-fracture or death: results of an analysis of administrative databases

  • L. Degli Esposti | luca.degliesposti@clicon.it CliCon S.r.l., Italy.
  • L. Sinigaglia
  • M. Rossini
  • S. Adami
  • C. Cagnoni
  • C. Magliaro
  • C. Veronesi
  • S. Buda
  • S. Minisola

Abstract

The aim of the present study was to evaluate the application into clinical practice of therapeutic and diagnostic recommendations for the prevention of bone re-fracture in postmenopausal women after an hospitalization for hip fracture in clinical practice and to assess the relationship between the application of diagnostic recommendations and re-fracture or death risk. A retrospective cohort analysis was conducted. All female patients, at least 65 years old, and with an hospitalization with main or secondary diagnosis of hip fracture during the period 1 January 2006 – 31 December 2008, were included. Besides demographic characteristics and comorbidities, drug treatment prescriptions related to bone fracture or supplementary with calcium or vitamin D and prescriptions of recommended laboratory and instrumental diagnostic tests (e.g. spine radiography), were analysed. A total of 5,636 patients were included in the study. The prescription of a drug treatment aimed to reduce the risk of re-fracture was found in 16.3% of patients, among them 76.3% (699 patients) used bisphosphonates only, 17.1% (157 patients) strontium ranelate only and 4.9% (45 patients) used more than one treatment during the observation period. Among the patients who did not receive drug treatment, 17.5% made use of only supplemental calcium and vitamin D. The remaining part of patients (69.1%) received no treatment. The prescription of at least one laboratory test of first and second level was performed, respectively, on 53.7% and 43.1% of included patients, whereas the prescription of at least one instrumental test of first and second level was performed, respectively, on 5.9% and 0.8%. Although it is established that the prescription of the recommended tests and appropriate drug treatment are significantly associated with reduced risk of re-fracture and death, today the application of these recommendations is reduced.

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Published
2012-03-16
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Articles
Keywords:
treatment adherence, pharmacoutilization, hip fracture, osteoporosis, refracture, death
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How to Cite
Degli Esposti, L., Sinigaglia, L., Rossini, M., Adami, S., Cagnoni, C., Magliaro, C., Veronesi, C., Buda, S., & Minisola, S. (2012). Adherence to therapeutic and diagnostic recommendations in patients with femur fracture and at risk of re-fracture or death: results of an analysis of administrative databases. Reumatismo, 64(1), 18-26. https://doi.org/10.4081/reumatismo.2012.18

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