Secondary fracture prevention after vertebral, femur or pelvic fracture at US academic medical center.

UNLABELLED: This study sought to assess rates of osteoporosis treatment following an index fragility vertebra, femur, or pelvic fracture at a US academic medical center. The results highlight persistent low treatment rates following fracture and emphasize the need for interventions such as formal fracture liaison programs to improve patient outcomes.

PURPOSE: Fragility fractures occur with low-energy trauma in patients with weakened bone strength and are associated with reductions in quality of life, function, and independence. The risk of re-fracture after a fragility fracture is significantly elevated. Prevention of secondary fractures is imperative as the population ages, given the morbidity, mortality, and costs directly attributable to these fractures. Unfortunately, treatment rates remain low despite the availability of effective therapies to reduce the risk of secondary fracture.

METHODS

We assessed the rate of pharmacologic treatment after vertebral, femur, or pelvic fracture within our academic medical center. In addition, we investigated potential factors, such as race or endocrinology consultation, which might influence post-fracture treatment.

RESULTS

Our sample included 814 females over age 65, who sustained a hip, pelvis, or vertebral fracture between January 2018 and December 2021. Within the sample, 29.7% received an anti-fracture prescription within 6 months of fracture. Those with osteoporosis included on their electronic health record (EHR) problem list had a significantly higher percent probability (28.6, 95% confidence interval (CI), 22.9, 34.3) of anti-fracture therapy prescription compared to those without osteoporosis on their problem list. Furthermore, Black patients were less likely to have a diagnosis of osteoporosis listed (p < 0.0001) and had a 10.9 percentage point lower probability of receiving a prescription compared to White patients (CI, 1.9, 19.9).

CONCLUSION

These results suggest that the majority of patients in our health care system did not receive effective pharmacotherapy for secondary fracture prevention. The study highlights the need for more effective interventions to reduce secondary fractures.