IMPROVING THE DIAGNOSIS RATE OF OSTEOPOROSIS IN WOMEN AFTER A FACTURE OF THE DISTAL RADIUS

Abstract

Introduction: Distal radius fracture in postmenopausal women is often the first clinical symptom of osteoporosis. Both patients and family physicians are generally unaware of this. It is estimated that only 15–25% of postmenopausal women with a distal radius fracture are further referred to perform a bone density examination. The purpose of the current study was to examine whether a simple intervention by the hospital staff would increase the percentage of patients that undergo diagnostic workup after suffering a fracture in the distal radius.

Patients and Methods: This prospective study included 99 women aged 48–70 seen in the emergency room for a distal radius fracture. All patients were contacted 6–8 weeks after the ER visit and asked as to whether they had received an explanation from the hospital or from the family physician about the significance of the fracture for osteoporosis, and whether they had been referred to a bone density examination. 49 patients served as a control group. The intervention group (50 patients) were then given a detailed explanation regarding the implications of the fracture for osteoporosis, and in addition, received a letter with an explanatory leaflet and an appeal to the family physician with recommendations and an article on osteoporosis.

An additional telephone survey was conducted 6–8 weeks after the first conversation to assess the influence of the intervention.

Results: 15 patients in the intervention group and 14 patients in the control group were lost to follow up or were already treated for osteoporosis before the fracture. At the second phone call 24 patients (72.7%) from the intervention group had contacted their family physician after the intervention, compared to 8 patients (22.9%) in the control group (p=0.0003). 14 patients (42.4%) from this group underwent a bone density examination, compared to 5 patients (14.3%) in the control group (p=0.0003).

Conclusion: It is of great importance that patients understand the connection between the current problem for which they are receiving treatment in the emergency setting and the possibility that there is an underlying cause. In addition the connection between the hospital and the community is very important in increasing the number of patients diagnosed and treated.