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The osteoporosis care gap in Canada.
A Papaioannou1, L Giangregorio, B Kvern
1Department of Medicine, McMaster University, Hamilton, Canada. papaioannou@hhsc.ca
BMC Musculoskeletal Disorders
|April 8, 2004
Summary
Many Canadians with fragility fractures are not diagnosed or treated for osteoporosis. This care gap highlights a need for improved osteoporosis management to prevent future bone fractures.
Area of Science:
- Geriatric Medicine
- Public Health
- Bone Health
Background:
- Fragility fractures are significant risk factors for osteoporosis.
- Osteoporosis assessment and treatment are indicated following a fragility fracture.
- Current osteoporosis management practices after fracture are not well-defined.
Purpose of the Study:
- To review literature on osteoporosis diagnosis and treatment in Canadian adults over 40 experiencing fragility fractures.
- To identify practice patterns and assess the care gap in osteoporosis management post-fracture.
Main Methods:
- Literature review of MEDLINE and CINAHL databases.
- Searches covered publications from 1966 to 2003.
- Focused on adults aged 40+ with fragility fractures in Canada.
Main Results:
- A significant care gap exists in Canadian osteoporosis diagnosis and treatment post-fracture.
- Osteoporosis diagnostic testing or physician diagnosis occurred in only 1.7% to 50% of patients.
- Therapeutic interventions (hormone replacement therapy, bisphosphonates, calcitonin) were prescribed to 5.2% to 37.5% of patients, with calcium and vitamin D supplementation varying widely.
Conclusions:
- A substantial number of Canadians experiencing fragility fractures do not receive adequate osteoporosis management.
- This lack of management increases the risk of subsequent fractures.
- Urgent improvements in osteoporosis care pathways are needed for fracture prevention.