title: [A fracture--intervention program optimizes the management of osteoporosis].
abstract: OBJECTIVE
  Despite the high morbidity and mortality rate of osteoporosis, the proportion of patients who receive appropriate diagnosis and treatment remains very low. A specific osteoporosis program increased the percentage of patients receiving diagnosis and/or treatment for osteoporosis. We set up a program to improve diagnosis and treatment of patients with low-trauma fractures or suspicion of osteoporosis.
  
  
  METHODS
  Two geriatricians were especially designated for this program. The program included patients admitted to the emergency room, inpatients and outpatients from the orthopedic department or the internal medicine/geriatric department. The assessment was performed over two visits and included an evaluation of risk factors for osteoporosis and falls, a physical examination, a collection of biological parameters, and Dual-energy X-ray absorptiometry. In the second visit the physician prescribed, if appropriate, anti-osteoporotic treatment.
  
  
  RESULTS
  During a two-year period, 156 patients were included in the program; 85.4 % were women. Hip fracture was the most common fracture, followed by vertebral and arm (respectively 28.6%, 11.5%, and 7.6%). While half the patients had a personal history of low-trauma fractures, only 17% received osteoporosis treatment. Anti-osteoporotic treatments were prescribed for 49% of the patients (p<0.001). It was mainly vitamin D (35%), calcium supplementation (31.2%), and oral bisphosphonate (23.6%). Inclusion in our program increased the number of patients receiving anti-osteoporotic treatment from 17.2 to 49.7%. All fallers received falls - prevention counseling based on written materials and oral information.
  
  
  CONCLUSIONS
  A specific program increases the percentage of patients receiving diagnosis and treatment for osteoporosis for patients with low-trauma fractures or suspicion of osteoporosis. Our next objectives are to develop this program to other health care's professionals.
authors.affiliation: Centre gérontologique départemental, Marseille, EA3279, Évaluation des systèmes de soins - santé perçue, Université de la Méditerranée, Marseille.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Retornaz
authors.forename: Valérie
authors.initials: V
authors.lastname: Seux
authors.forename: Vanessa
authors.initials: V
authors.lastname: Pauly
authors.forename: Sonia
authors.initials: S
authors.lastname: Nouvellet
authors.forename: Xavier
authors.initials: X
authors.lastname: Flecher
authors.forename: Jacques
authors.initials: J
authors.lastname: Soubeyrand
authors.forename: Odile
authors.initials: O
authors.lastname: Reynaud-Levy
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000284:Administration, Oral; D000368:Aged; D002118:Calcium / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D004164:Diphosphonates / Q000008:administration & dosage; D005260:Female; D016330:Frail Elderly; D005602:France; D005853:Geriatrics; D006801:Humans; D008297:Male; D009098:Multiphasic Screening; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D004164:Diphosphonates; D014807:Vitamin D; D002118:Calcium