title: A simple intervention for improving the implementation rate of a recommended osteoporosis treatment after hip fracture.
abstract: OBJECTIVE
  Osteoporosis is often under-treated, and hip fracture is frequently its first manifestation. Hospitalization for a hip fracture is an opportunity to initiate osteoporosis treatment. The aim of this study was to investigate whether a simple intervention improves the implementation rate of a recommended osteoporosis treatment.
  
  
  METHODS
  One hundred elderly patients admitted with low-impact hip fracture were given a 10 minute explanation about osteoporosis and its treatment during their postoperative hospital stay. In addition, the patients received an explanatory brochure and a letter to their primary care physician that included an article on fracture rate reduction with osteoporosis treatment. Implementation of therapy was assessed by a telephone survey 3 and 6 months postoperatively. The patients who had not received treatment at 3 months were given a repeated explanation. The historical control group was comprised of 100 hip fracture patients with similar demographic characteristics, who were operated on and discharged with the standard care recommendations for osteoporosis prevention.
  
  
  RESULTS
  At the 3 month follow-up, the therapy rate in both groups was similar (19%). Fifty-eight percent of the patients in the study group had no recollection of the intervention. However, after a repeated explanation, at the 6 month follow-up, 39% of the intervention group had received drug therapy for fracture prevention (P<.001).
  
  
  CONCLUSIONS
  A simple intervention enlisting the patients' help to involve their primary care physician can increase treatment rates for osteoporosis following a hip fracture. During the immediate postoperative period, the patients and their families have difficulty implementing the recommendations. Therefore, repeated communications are recommended.
authors.affiliation: Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. kandel@hadassah.org.il
authors.forename: Leonid
authors.initials: L
authors.lastname: Kandel
authors.forename: David
authors.initials: D
authors.lastname: Schler
authors.forename: Mayer
authors.initials: M
authors.lastname: Brezis
authors.forename: Meir
authors.initials: M
authors.lastname: Liebergall
authors.forename: Yoav
authors.initials: Y
authors.lastname: Mattan
authors.forename: Rivka
authors.initials: R
authors.lastname: Dresner-Pollak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002112:Calcifediol / Q000097:blood; D003695:Delivery of Health Care; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006620:Hip Fractures / Q000097:blood / Q000209:etiology*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D002112:Calcifediol