title: Results of a model of secondary prevention for osteoporotic fracture coordinated by rheumatology and focused on the nurse and primary care physicians.
abstract: OBJECTIVE
  To assess the influence of the implementation of a program for secondary prevention of osteoporotic fractures on prescribing bisphosphonates and persistent short-term treatment.
  
  
  METHODS
  Patients >50 years with fragility fracture attended in the emergency department were enrolled in an observational study. The program consisted of: 1) training of primary care physicians, 2) baseline visit: questionnaire on osteoporosis, bone densitometry and patient education, 3) patient referral to primary care, except those with multiple fractures or requiring special study or therapy, who were referred to a specialist, and 4) follow-up by checking prescriptions in electronic records, and a telephone survey. The outcome variable was the percentage of patients who, on having been prescribed bisphosphonates, still adhered to the treatment at 3 months.
  
  
  RESULTS
  Of the 532 patients with inclusion criteria, 202 (39%) refused to participate. Those who refused to take part had a higher mean age (P<.01) and a higher frequency of hip fracture (P<.01) compared with patients who did participate. A total of 330 patients were included for intervention, with a mean age of 71 years, and 254(77%) were female. An antiresorptive was being used by 45 patients (13%) at baseline. After the baseline visit 223 patients (67%) were recommended a bisphosphonate. In the follow-up at 3 months 78% of patients who had been prescribed bisphosphonate were still receiving treatment.
  
  
  CONCLUSIONS
  We present a multidisciplinary program for secondary prevention of fractures coordinated by rheumatology in which the number of patients who were receiving bisphosphonate at 3 months increased by four times compared to baseline visit.
authors.affiliation: Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España; Departamento de Ciencias Médicas y Quirúrgicas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España. Electronic address: anarher@gobiernodecanarias.org.
authors.forename: Antonio
authors.initials: A
authors.lastname: Naranjo
authors.affiliation: Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
authors.forename: Soledad
authors.initials: S
authors.lastname: Ojeda-Bruno
authors.affiliation: Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Bilbao Cantarero
authors.affiliation: Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Quevedo Abeledo
authors.affiliation: Departamento de Ciencias Clínicas, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España; Servicio de Oncología Radioterápica, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
authors.forename: Luis Alberto
authors.initials: LA
authors.lastname: Henríquez-Hernández
authors.affiliation: Servicio de Reumatología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodríguez-Lozano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009729:Nursing; D058866:Osteoporotic Fractures / Q000517:prevention & control*; D010348:Patient Care Team; D011320:Primary Health Care; D011446:Prospective Studies; D012189:Retrospective Studies; D012219:Rheumatology; D055502:Secondary Prevention
chemical_list: D004164:Diphosphonates
keywords: Alendronate; Bisfosfonatos; Bisphosphonates; Fractura por fragilidad; Fragility fracture; Osteoporosis; Prevención secundaria; Secondary prevention; Training program