title: [Management of the patient with a high risk of fracture in clinical practice. Results from a survey of 174 Spanish Rheumatologists (OSTEOPAR project)].
abstract: OBJECTIVE
  To collect information about diagnosis, classification and treatment of patients at high risk of fracture in the rheumatologist's practice.
  
  
  METHODS
  A survey was conducted among Spanish rheumatologists. The survey was aimed at gathering data on the physician's healthcare activity, the osteoporosis (OP) and fracture risk factors considered as most relevant, the diagnostic used tests and the treatment indication according to the presence of different risk factors.
  
  
  RESULTS
  99.5% of rheumatologists felt that there is a group of patients with OP at high risk of fracture. Previous fracture was considered the most important risk factor, particularly in case of multiple fractures, severe fractures, hip fracture, or that occurred during treatment. Glucocorticoid treatment, older age and low bone mineral density were considered, in this order, other important risk factors. The number of vertebral fractures was considered the most relevant radiological data, followed by the fracture's chronology and severity. Most of the respondents selected teriparatide as the first treatment option in high-risk patients.
  
  
  CONCLUSIONS
  The definition of OP patient with high risk of fracture is not uniform in daily practice, although the majority of rheumatologists considered that having a previous fracture is the most important risk factor, followed by glucocorticoid treatment, older age and low BMD. Anabolic treatment was the approach most commonly used in OP patients with high risk of fracture.
authors.affiliation: Servicio de Reumatología, Hospital de Sabadell, Institut Univesitari Parc Taulí (UAB), Sabadell, Barcelona, España. ecasado@tauli.cat
authors.forename: Enrique
authors.initials: E
authors.lastname: Casado
authors.forename: Manuel
authors.initials: M
authors.lastname: Caamaño
authors.forename: Juan
authors.initials: J
authors.lastname: Sánchez-Bursón
authors.forename: Esteban
authors.initials: E
authors.lastname: Salas
authors.forename: Jorge
authors.initials: J
authors.lastname: Malouf
authors.forename: María Luz
authors.initials: ML
authors.lastname: Rentero
authors.forename: Gabriel
authors.initials: G
authors.lastname: Herrero-Beaumont
mesh_terms: D001291:Attitude of Health Personnel; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000209:etiology / Q000517:prevention & control*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012219:Rheumatology; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D013030:Spain; D011795:Surveys and Questionnaires; D019379:Teriparatide / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D019379:Teriparatide