title: The T.A.R.Ge.T. project: a regional program to reduce hip fracture in elderly patients. Main results of retrospective phase.
abstract: The Tuscany Region was the first Italian Region to initiate a program for the prevention of hip fractures in over 65 year old. The T.A.R.Ge.T. project "Appropriate treatment of geriatric re-fractures in Tuscany" (Trattamento Appropriato delle Rifratture Geriatriche in Toscana), which is still on-going, includes a preliminary phase (2009-2010) for baseline analysis and education of the participating centers and a 4-year-prospective phase (2011-2014). The monitoring system is performed horizontally analyzing 5 different flows: SDO (Performance Hospitalization), SPF (Pharmaceutical Distribution Dataset), FED (Direct Distribution Dataset), SAA (Registry of Patients), SPA (Specialized Outpatient) flows. In this review will be shown some of the most important results of analyzes of the retrospective phase. Between 2006 and 2011 only 26% of hip fractured patients has being treated with anti-osteoporotic drugs. The percentage of treatment increases 10% after the second fracture. Until 2011 there wasn't in Tuscany a prevention program of bone fragility; patients were treated with specific treatment only in severe cases: this phenomenon implies that mortality and re-fracture are higher on treated patients than in patients who did not have any kind of treatment. The treated patients are the most severe and therefore they have a higher risk of death and re-fracture.
authors.affiliation: Bone Metabolic Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Parri
authors.affiliation: Bone Metabolic Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
authors.forename: Luisella
authors.initials: L
authors.lastname: Cianferotti
authors.affiliation: Bone Metabolic Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
authors.forename: Gemma
authors.initials: G
authors.lastname: Marcucci
authors.affiliation: Department of Psychology, University of Florence, Florence, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gronchi
authors.affiliation: Tuscany Regional Healthcare System, Florence, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Rizzuti
authors.affiliation: Bone Metabolic Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Colli
authors.affiliation: Tuscany Region, "Information System to support decisions" Department; Regional Statistics Office, Florence, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Manetti
authors.affiliation: Tuscany Region, "Information System to support decisions" Department; Regional Statistics Office, Florence, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Naldoni
authors.affiliation: Bone Metabolic Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Brandi
keywords: anti-fracture drugs; fractures; hip; institutional database; persistence; re-fractures