Factors influencing diagnosis and treatment of osteoporosis after a fragility fracture among postmenopausal women in Asian countries: a retrospective study

BMC Women's Health

Research Article

Joon Kiong Lee¹  Wei B Xia²  Annie W Kung³  Ling Xu⁴  Il Hyung Park⁵  Hak Sun Kim⁶  Thana Turajane⁷  Leonard Koh⁸  Shuvayu Sen⁹  Tao Fan^1,10  Yung Kuei Soong^1,11  Suppasin Soontrapa^1,12  Thawee Songpatanasilp^1,13  Marc Yates^1,14  Siew Pheng Chan^1,15 

[1] Assunta Hospital, Petaling Jaya, Malaysia;Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China;Department of Medicine

[2] , The University of Hong Kong, Hong Kong, China;Department of Obstetrics and Gynecology, Beijing Union Medical Hospital, Beijing, China;Department of Orthopaedic Surgery, Kyung Pook National University Hospital, Daegu, South Korea;Department of Orthopaedic Surgery, Yongdong Severance Hospital, Seoul, South Korea;Department of Orthopedics, Faculty of Medicine, Ramathibidi Hospital, Mahidol University, Maharaj Nakorn Chiangmai Hospital & Chiang Mai University, Chiang Mai, Thailand;Gleneagles Medical Centre, Singapore, Singapore;Global Outcomes Research, Merck & Co., Inc, Whitehouse Station, USA;Global Outcomes Research, Merck & Co., Inc, Whitehouse Station, USA;Global Human Health, Outcomes Research, WS2E-76, Merck Sharp and Dohme, One Merck Drive, 08889, Whitehouse Station, NJ, USA;Medical college, Chang Gung University, Kwei-Shan, Taiwan;Orthopaedics and Rehabilitation medicine, Khon Kaen University, Khon Kaen, Thailand;Phramongkutklao Army Hospital and College of Medicine, Bangkok, Thailand;The Research Partnership, Singapore, Singapore;University Malaya Medical Center, Kuala Lumpur, Malaysia;

关键词: Osteoporosis;    Bone density;    Female;    Fractures;    Asia;   

DOI  :  10.1186/1472-6874-13-7

 received in 2012-06-28, accepted in 2013-01-28,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundA vast amount of literature describes the incidence of fracture as a risk for recurrent osteoporotic fractures in western and Asian countries. Osteoporosis evaluation and treatment after a low-trauma fracture, however, has not been well characterized in postmenopausal women in Asia. The purpose of this study was to characterize patient and health system characteristics associated with the diagnosis and management of osteoporosis among postmenopausal women hospitalized with a fragility fracture in Asia.MethodsPatient surveys and medical charts of postmenopausal women (N=1,122) discharged after a fragility hip fracture from treatment centers in mainland China, Hong Kong, Singapore, South Korea, Malaysia, Taiwan, and Thailand between July 1, 2006 and June 30, 2007 were reviewed for bone mineral density (BMD) measurement, osteoporosis diagnosis, and osteoporosis treatment.ResultsThe mean (SD) age was 72.9 (11.5) years. A BMD measurement was reported by 28.2% of patients, 51.5% were informed that they had osteoporosis, and 33.0% received prescription medications for osteoporosis in the 6 months after discharge. Using multivariate logistic regression analyses, prior history of fracture decreased the odds of a BMD measurement (OR 0.63, 95% CI 0.45-0.88). Having a BMD measurement increased the odds of osteoporosis diagnosis (OR 10.1, 95% CI 6.36-16.0), as did having health insurance (OR 4.95, 95% CI 1.51-16.21 for private insurance with partial self-payment relative to 100% self-payment). A history of fracture was not independently associated with an osteoporosis diagnosis (OR 0.80, 95% CI 0.56-1.15). Younger age reduced the odds of receiving medication for osteoporosis (OR 0.59, 95% CI 0.36-0.96 relative to age ≥65), while having a BMD measurement increased the odds (OR 1.79, 95% CI 1.23-2.61).ConclusionsOsteoporosis diagnosis and treatment in Asian countries were driven by BMD measurement but not by fracture history. Future efforts should emphasize education of general practitioners and patients about the importance of fracture.

【 授权许可】

Unknown   
© Kung et al; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.