title: Treatment and Management of Osteoporotic Fractures: A Nation-wide Survey of 484 Senior Orthopaedists in China.
abstract: OBJECTIVE
  To investigate the treatment given to osteoporotic fracture patients by orthopaedists at major hospitals in China.
  
  
  METHODS
  A 25-item quantitative questionnaire survey, categorized into five domains, including primary purpose of osteoporosis treatment, anti-osteoporosis therapy, calcium and vitamin D supplement, monitoring of osteoporosis, and knowledge of osteoporosis treatment, was designed to elicit information on orthopaedists' views on the treatment of osteoporotic fracture. A pre-survey test was conducted with a sample of 40 orthopaedic specialists to confirm the reliability and validity of the questionnaire. Each interview of the survey took approximately 15 min and did not directly involve any patients. The survey was conducted through face-to-face interviews at 119 tier 3 hospitals in 28 cities across Mainland China.
  
  
  RESULTS
  A total of 484 valid responses were received. Seven in ten respondents have ≥10 years of professional practice. While two-thirds believed that osteoporosis treatment was to prevent fractures or re-fractures, 95.0% agreed that anti-osteoporosis medication should be administered to patients with a history of fragility fractures. Three in four would prescribe anti-osteoporosis medication perioperatively. Of these, 79.0% regarded bisphosphonates as the first-line drug. Approximately 86.0% of the 21-30 years cohort chose bisphosphonates compared to 71.4% for those with ≤10 years. More of the younger (≤10 years) cohort chose calcitonin compared to their older (21-30 years) colleagues (25.7% vs 11.6%). The most commonly prescribed daily dose is 800 IU for vitamin D supplements and 600 mg/day for calcium.
  
  
  CONCLUSIONS
  Our respondents generally adhered to guidelines for the treatment and management of osteoporosis. A significant number had recommended lower dosages of vitamin D and calcium. Some differences exist between the younger cohort and their older colleagues in the prescription of pharmacological therapies. The criteria for initiating therapy should be more holistic and include other factors besides bone mineral density (BMD). Our results demonstrated that more comprehensive guidelines for osteoporosis management and a greater awareness of these guidelines by orthopaedists are needed to enable them to better manage their patients.
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Man
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Pan
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Lu
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Sen-Yuan
authors.initials: SY
authors.lastname: Li
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Pian
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Jun-Zhe
authors.initials: JZ
authors.lastname: Guo
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Shu-Fang
authors.initials: SF
authors.lastname: Yu
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: En
authors.initials: E
authors.lastname: Xiao
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zuo
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: He-Juan
authors.initials: HJ
authors.lastname: Jin
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Xiao-En
authors.initials: XE
authors.lastname: Shi
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Di
authors.initials: D
authors.lastname: Hong
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Liu
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Ying-Xu
authors.initials: YX
authors.lastname: Gao
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Beijing Novartis Pharma, Beijing, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Yin
authors.affiliation: Department of Orthopaedics, Beijing, China.|National Center of Gerontology, Beijing Hospital, Beijing, China.
authors.forename: Qing-Yun
authors.initials: QY
authors.lastname: Xue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002681:China; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D008875:Middle Aged; D009985:Orthopedics; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012008:Recurrence; D055502:Secondary Prevention / Q000379:methods / Q000706:statistics & numerical data*
chemical_list: D050071:Bone Density Conservation Agents
keywords: 
  Diagnosis; 
  Osteoporosis; 
  Osteoporotic fracture; 
  Survey; 
  Treatment