title: Secondary prevention of vertebral fractures in a large New Zealand District Health Board.
abstract: BACKGROUND
  International data suggests osteoporotic vertebral fractures are undertreated. The aim of this audit was to identify treatment gaps in patients with known vertebral fractures at Waitemata District Health Board (WDHB).
  
  
  METHODS
  Retrospective review of patients admitted to WDHB from July 2006 to June 2007. Inclusion criteria were age over 65 years, admission to any service with a primary or secondary diagnosis of vertebral fracture. Exclusion criteria were fractures related to malignancy. Demographic data, details of vertebral fracture, and history of prior fractures were documented. Osteoporotic medications at admission and discharge were collected.
  
  
  RESULTS
  We analysed 154 patients. The mean age was 81.5 years and 101 (66%) were women. At discharge, 42 (27%) of patients were on no treatment and 51 (33%) were treated with calcium, vitamin D and a bisphosphonate. Men were significantly more likely to be on no treatment (p<0.05). Lack of treatment did not appear to be associated with age or frailty. Subgroups studied included patients with prior non-vertebral fractures, primary diagnosis of vertebral fracture and patients on corticosteroids with rates of no treatment of 20%, 21% and 16% respectively.
  
  
  CONCLUSIONS
  Secondary treatment of vertebral fractures in patients admitted to WDHB is suboptimal. Men were particularly affected.
authors.affiliation: Department of Geriatric Medicine, University of Auckland and Waitemata District Health Board, 120 Shakespeare Road, PO Box 93 503 Takapuna, North Shore 0740, Auckland, New Zealand. Katherine.bloomfield@waitematadhb.govt.nz
authors.forename: Katherine
authors.initials: K
authors.lastname: Bloomfield
authors.forename: Joe
authors.initials: J
authors.lastname: Singh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D010024:Osteoporosis / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D055502:Secondary Prevention; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D004164:Diphosphonates; D014807:Vitamin D; D002118:Calcium