title: Factors predictive of the perceived osteoporosis-fracture link in fragility fracture patients.
abstract: OBJECTIVE
  Given the asymptomatic nature of osteoporosis, a fragility fracture provides an opportunity to make the issue of osteoporosis relevant to patients. Patients who link their fragility fracture with osteoporosis are more likely to initiate osteoporosis treatment, yet to date, we know little about who is likely to make this link. This study examined whether demographic, health, and osteoporosis belief factors predicted a perceived link between a fragility fracture and osteoporosis.
  
  
  METHODS
  This longitudinal cohort study analyzed baseline and follow up data collected as part of a provincial osteoporosis screening initiative targeting fragility fracture patients. Logistic regression analysis was used to examine the relationship between hypothesized predictors and the outcome.
  
  
  METHODS
  Patient perception of the osteoporosis-fracture link at follow up.
  
  
  RESULTS
  At baseline, 93% (1615/1735) of patients did not believe their fracture could have been caused by osteoporosis. Of these, only 8.2% changed this perception at follow up. Adjusted analyses showed that baseline characteristics associated with making the osteoporosis-fracture link at follow up were: a previous fracture (odds ratio (OR) 1.7, confidence interval (CI) 1.2-2.6), perception of osteoporosis pharmacotherapy benefits OR 1.2 (CI 1.0-1.5), diagnosis of rheumatoid arthritis OR 2.6 (CI 1.4-4.9) and the perception of bones as "thin" OR 8.2 (CI 5.1-13.1).
  
  
  CONCLUSIONS
  These results shed more light on patient-level barriers to osteoporosis management following an osteoporosis educational programme. They may be used to identify patients less likely to make the link between their fracture and osteoporosis and to inform interventions for this patient group.
authors: Mobility Program Clinical Research Unit, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. sujicr@smh.ca
authors: Rebeka
authors: R
authors: Sujic
authors: Monique A
authors: MA
authors: Gignac
authors: Rhonda
authors: R
authors: Cockerill
authors: Dorcas E
authors: DE
authors: Beaton
mesh_terms: D000368:Aged; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005598:Fractures, Spontaneous / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010024:Osteoporosis / Q000453:epidemiology* / Q000523:psychology*; D010465:Perception; D012307:Risk Factors
keywords: Fragility fractures; Osteoporosis; Patient perception; Post-fracture intervention