title: Bone health evaluation in a veteran population: a need for the Fracture Risk Assessment Tool (FRAX).
abstract: BACKGROUND
  Approximately 2 million men in the United States have osteoporosis, but men are seldom evaluated or treated to prevent fracture. In the expanding veteran population, the fracture risk assessment tool, FRAX, could help reduce fracture risk. However, it is unknown how many veterans would meet the FRAX treatment threshold.
  
  
  OBJECTIVE
  To determine the proportion of untreated veterans who should be considered for osteoporosis treatment according to the Fracture Risk Assessment Tool (FRAX) among a randomly selected sample of older veterans receiving care at one Veterans Hospital and to determine the proportion of veterans in the sample who had received treatment.
  
  
  METHODS
  A retrospective review of 150 randomly selected charts from male veterans at least 70 years of age and female veterans at least 65 years of age receiving primary care at the William S. Middleton Memorial Veterans Hospital, Madison, WI, between January 1, 2007, and October 1, 2010. This study focused on men, but women were included per institutional review board policy.
  
  
  RESULTS
  Charts from 147 men and 3 women were reviewed; 25 men had received osteoporosis treatment. Of 122 untreated men, 74 (61%) met FRAX treatment criteria, including 14 who had fractured. Although bone density testing is recommended by the National Osteoporosis Foundation for men at least 70 years old, only 21 (17%) untreated men had been tested.
  
  
  CONCLUSIONS
  Most veterans who met FRAX criteria were not treated, including some who had had fractures. The VA should consider recommending FRAX to identify veterans at high risk for fracture.
authors.affiliation: La Crosse VA Outpatient Clinic, LaCrosse, WI, USA.
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Ackman
authors.affiliation: William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
authors.forename: Paul F
authors.initials: PF
authors.lastname: Lata
authors.affiliation: William S. Middleton Memorial Veterans Hospital, Madison, WI, USA University of Wisconsin School of Pharmacy, Madison, WI, USA.
authors.forename: Arthur A
authors.initials: AA
authors.lastname: Schuna
authors.affiliation: William S. Middleton Memorial Veterans Hospital, Madison, WI, USA University of Wisconsin School of Pharmacy, Madison, WI, USA meelliott@pharmacy.wisc.edu.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Elliott
mesh_terms: D000368:Aged; D015519:Bone Density; D050723:Fractures, Bone / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D014481:United States; D014728:Veterans
keywords: men; osteoporosis; osteoporosis assessment; osteoporosis treatment