title: Screening for osteoporosis reduced new fracture incidence by almost half: a 6-year follow-up of 592 fracture patients from an osteoporosis screening program.
abstract: OBJECTIVE
  Fractures can be prevented if osteoporosis is identified and treated. In 2002, we initiated a screening program at our orthopedics department, in which patients between 50 and 75 years of age with a wrist, shoulder, vertebral, or hip fracture are assessed by DEXA of the hip and spine and encouraged to see their doctor for decision on treatment regarding osteoporosis. The patients receive written documents containing information, DEXA results, and a letter to their doctor with suggestions regarding blood tests and treatment. In this 6-year follow-up study, we compared the fracture recurrence in 2 groups: patients screened for osteoporosis after fracture as described, and a historical control group with fracture patients who presented at our department 1 year before we started the screening intervention.
  
  
  METHODS
  A questionnaire was sent to the 2 groups of fracture patients, those from before the time that we started the screening in 2002 and those who participated in the initial screening study in 2003. The questionnaire included questions on whether they had sustained further fractures, whether they had seen a doctor, and whether treatment had been initiated.
  
  
  RESULTS
  239 of the 306 unscreened patients (68%) and 219 of the 286 screened patients (77%) answered the questionnaire. In the unscreened group, 69 new fractures had occurred, in contrast to 39 in the screened group. The fracture risk was 42% lower in the screened group. Answers regarding treatment were incomplete in the unscreened group.
  
  
  CONCLUSIONS
  Screening of fracture patients for osteoporosis reduced fracture recurrence, which indicates that the screening procedure has resulted in treatment that prevents fractures.
authors.affiliation: Orthopaedics Unit, Department of Clinical Sciences, Medical Faculty, Lund University, Sweden. jorgen.astrand@med.lu.se
authors.forename: Jörgen
authors.initials: J
authors.lastname: Astrand
authors.forename: Johan
authors.initials: J
authors.lastname: Nilsson
authors.forename: Karl-Göran
authors.initials: KG
authors.lastname: Thorngren
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000453:epidemiology; D015397:Program Evaluation; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D013997:Time Factors