For A.M. Release
Tuesday, August 8, 2000
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Joanne Swanson
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Lisa Doty
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Study finds postmenopausal women's osteoporosis treatment inadequate
ROSEMONT, Ill.--Women over age 55 who break their wrist should be treated for osteoporosis, but a new study shows that only a quarter of these women are being treated.
Researchers at the University of Pennsylvania evaluated the adequacy of physicians' diagnosis and treatment of osteoporosis in 1,162 postmenopausal women who sustained a wrist fracture.
"Although a broken wrist is often this group's first sign of osteoporosis, only 24 percent (279) were given any diagnostic tests or medication for the disease in the six months following the fracture," reported co-author Kevin B. Freedman, MD, who conducted the study while chief orthopaedic resident and fellow at the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia. Dr. Freedman is now an orthopaedic surgeon in private practice in Allentown, Penn.
The findings are published in the August issue of The Journal of Bone and Joint Surgery, the official scientific publication of the American Academy of Orthopaedic Surgeons.
According to Dr. Freedman, postmenopausal women who sustain a wrist fracture may have decreased bone mineral density overall and double the risk of a future hip fracture.
"The incidence of wrist fracture increases 15 years before that of hip fracture," he said. "Osteoporosis is very likely to be present in women with wrist fractures, and steps can therefore be taken to preserve bone mass and prevent future fractures.
"Achieving even small increases in bone density can reduce fracture risk," said Dr. Freedman. "Providers and patients need more education about the benefits of osteoporosis treatment."
Dr. Freedman and colleagues analyzed patient records for medical and pharmacy claims recorded for six months after the wrist fracture. "The rate of diagnosis and treatment for osteoporosis was even lower for older women than for the entire over 55 group, despite the fact that these women are at the highest risk for hip fracture," he said.
Only 9.1 percent of participants age 85- to 89-years-old were treated for osteoporosis; 4.2 percent of those 90- to 94-years-old were treated; and 4.7 percent of those 95-years-old or older were treated. "Yet, treatment can increase bone mass and reduce fracture incidence," said Dr. Freedman.
"Physicians now have an excellent opportunity to decrease the 350,000 hip fractures that occur each year in the U.S., a number that, with the aging population, could reach 650,000 by the year 2050."
From the University of Pennsylvania, co-authors of the study with Dr. Freedman are Frederick S. Kaplan, MD, Isaac & Rose Nassau professor of orthopaedic molecular medicine and chief, division of metabolic bone diseases and molecular orthopaedics; and Warren B. Bilker, PhD, assistant professor of biostatistics, department of biostatistics and epidemiology. Also from the University of Pennsylvania are co-authors Brian L. Strom, MD, director, center for clinical epidemiology and biostatistics; chair, department of biostatistics and epidemiology; and professor of biostatistics and epidemiology, medicine, and pharmacology; and Robert A. Lowe, MD, assistant professor of epidemiology and assistant professor of emergency medicine.
An orthopaedic surgeon is a medical doctor with extensive training in the diagnosis and treatment of injuries and diseases of the musculoskeletal system-the bones, joints and muscles of the body.
The Journal of Bone and Joint Surgery (JBJS) is the official scientific publication of the 24,500-member American Academy of Orthopaedic Surgeons (www.aaos.org), a not-for-profit organization which provides educational programs for orthopaedic surgeons, allied health professionals and the public.
The Academy is participating in the Bone and Joint Decade (www.bonejointdecade.org), the global initiative in the years 2000-2010 to raise awareness of people's musculoskeletal health care needs.
The peer-reviewed JBJS, located in Needham, Mass., is published monthly. Abstracts are available online at http://www.jbjs.org.
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