title: Quality of care provided to prostate cancer (PC) patients for prevention and treatment of osteoporosis induced by androgen deprivation therapy (ADT).
abstract: This study aims to evaluate the quality of care (QOC) and use of validated risk algorithms provided in a specialized osteoporosis clinic to men with prostate cancer on androgen deprivation therapy (ADT) who are at risk of bone loss and fragility fractures.
  
  
  
  Charts for 100 consecutive men (mean age 73.0 years) on ADT referred to a tertiary osteoporosis clinic in Toronto, Canada between 2010 and 2014 were reviewed. The following QOC issues were examined: (a) bone health services provided, i.e., screening, preventing, and treating osteoporosis; and (b) use of national guidelines and fracture risk assessment tools for targeting appropriate therapy.
  
  
  
  The median (IQR) duration of ADT was 21.4 (26.9) months at the baseline visit. Nineteen patients had their first bone mineral density test before starting ADT and 34 during the first year of use. At initial consultation, 83 and 30 patients were taking inadequate amounts of calcium and vitamin D, respectively. A validated fracture risk assessment tool was used in all patients; 42 had a moderate 10-year fracture risk and 12 were high risk. Sixteen (72.7 %) of sedentary patients were advised to increase physical activity. Sixty-four (77.1 %) and 28 (93.3 %) of patients not taking appropriate amounts of calcium and vitamin D, respectively, were recommended to adjust their intake to guideline levels. All patients at high fracture risk were recommended a bisphosphonate.
  
  
  
  The majority of referred patients had moderate to high fracture risk. The osteoporosis clinic recommended guideline-based bone health care for the vast majority of men on ADT.
authors.affiliation: Department of Medicine, University Health Network, Toronto, ON, Canada.
authors.forename: Rehab
authors.initials: R
authors.lastname: Chahin
authors.affiliation: Department of Medicine, University Health Network, Toronto, ON, Canada.
authors.forename: Husayn
authors.initials: H
authors.lastname: Gulamhusein
authors.affiliation: Department of Medicine, University Health Network, Toronto, ON, Canada.
authors.forename: Henriette
authors.initials: H
authors.lastname: Breunis
authors.affiliation: Department of Medicine, University Health Network, Toronto, ON, Canada. shabbir.alibhai@uhn.on.ca.|Department of Medicine, University of Toronto, Toronto, ON, Canada. shabbir.alibhai@uhn.on.ca.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. shabbir.alibhai@uhn.on.ca.|Toronto General Hospital, 200 Elizabeth St, Room EN14-214, Toronto, ON, M5G 2C4, Canada. shabbir.alibhai@uhn.on.ca.
authors.forename: Shabbir M H
authors.initials: SM
authors.lastname: Alibhai
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D050723:Fractures, Bone / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000517:prevention & control* / Q000628:therapy; D011471:Prostatic Neoplasms / Q000150:complications* / Q000188:drug therapy; D011787:Quality of Health Care; D018570:Risk Assessment
chemical_list: D000726:Androgen Antagonists
keywords: Androgen deprivation therapy; Bone health; Prostate cancer; Quality of care