A SIMPLE INTERVENTION FOR INCREASING COMPLIANCE IN OSTEOPOROSIS TREATMENT AFTER HIP FRACTURE.

Abstract

Osteoporosis is a very common disease in the elderly, generally undertreated. Hip fracture is often the first clinical painful symptom of osteoporosis. It would seem that hip fracture should be a good opportunity to convince the patient of the importance of osteoporosis treatment. We conducted this study to check whether a simple intervention improved the compliance of osteoporosis treatment.

100 consecutive elderly patients with osteoporotic hip fracture received, during postoperative hospital stay, a 5–10 minutes long explanation about osteoporosis, its sequelae, treatment options and their effectiveness in further fracture prevention. Patients received an explanatory brochure and a letter to family physician that included a recent article on fracture rate reduction with osteoporosis treatment. Compliance was examined by telephone survey 3 and 6 months postoperatively.

100 consecutive patients with similar demographic characteristics who were treated for hip fracture prior to intervention served as a historical control. All patients received a recommendation for osteoporosis treatment in the discharge letter.

At follow up, 40% of patients in the study group were receiving biphosphonates, as opposed to 20% in the control group (p< 0.01). 77% of control patients received no treatment for osteoporosis compared to 37% of patients after intervention (p< 0.01).

Giving the patient a short explanation about osteoporosis combined with a letter to family physician, resulted in a significant improvement in their compliance The orthopaedic surgeon, who treats the patient at the first painful symptom of osteoporosis, has an excellent opportunity to improve patient’s understanding of the disease and her or his compliance to treatment.