[Osteoporosis prevention in general practice after hospitalization for hip fracture]

The aim of the study was to assess: 1) the degree of osteoporosis preventative therapy initiated by general practitioners (GP) after hospitalisation for a hip fracture; 2) the GPs' opinion of osteoporosis preventative therapy, and their opinion on whether it should be initiated by the hospital or the GP; 3) the need for a reference programme.

The GPs of patients discharged after a hip fracture in 1997-1998, were sent two questionnaires: one concerning osteoporosis preventative therapy of the patient and one concerning the GPs' own opinion on prevention.

A total of 107 patients (80% women, 20% men) met the criteria of the study. Eighty-seven per cent were seen by their GP within six months of discharge, 16% were started on preventative therapy, which was: 53% calcium/calcium + vitamin D, 40% etidronate, and 27% estrogen. No one chose alendronate, raloxifen, or hip protector. Eighty-four per cent were not treated, of these 18% did not want to be treated, poor patient compliance was expected in 11%, and 6% of the GPs did not find the scientific documentation convincing. Four per cent had been referred for a bone scan, and 2% to X-ray of the vertebral column. Of the GPs, 52% felt it should be the patients' own GP who started the therapy, 48% felt it should be the discharging hospital physician, 83% felt they were capable of treating this condition. Sixty-nine per cent of the GPs felt a need for a reference programme, 96% wished to have access to refer patients for a bone scan.

Only 16% were started on osteoporosis preventative therapy after a hip fracture. The study shows a need for better co-operation and communication between hospital physicians and GPs, and a need for a reference programme.