PRELIMINARY RESULTS OF MULTIDISCIPLINARY SYSTEMATIC FOLLOW-UP OF FRAGILITY FRACTURES IN ORTHOPAEDIC CLINIC

Author(s)

Fernandes J¹, Delisle J¹, Perreault S², Beaumont P¹, Gagnon S¹, Giroux M³, Jodoin A¹, Laflamme Y¹, Leduc S¹, MacThiong J¹, Malo M¹, Maurais G¹, Nguyen H³, Parent S¹, Ranger P¹, Raynauld JR⁴, Rouleau D¹, Troyanov Y¹
¹Hôpital du Sacré Coeur de Montréal, Montreal, QC, Canada, ²Université de Montréal, Montréal, QC, Canada, ³Hôpital Jean Talon, Montreal, QC, Canada, ⁴Institut de Rhumatologie de Montréal, Montreal, QC, Canada

Presentation Documents

PMS84-fernandes-j-sup-1-sup-delisle-j-sup-1-sup-strong-u-perreault-s-u-sup-2-sup-strong-beaumont-p-sup-1-sup-gagnon-s-sup-1-sup-giroux-m-sup-3-sup-jodoin-a-sup-1-sup-laflamme-y-sup-1-sup-leduc-s-sup-1-sup-macthiong-j-sup-1-sup-malo-m-sup-1- ...

OBJECTIVES: Despite the major health care impact worldwide of fragility fracture, there are few systems in place to identify and capture subjects after a fragility fracture to ensure appropriate assessment and treatment to reduce future fracture risk and adverse outcomes. We implemented a multidisciplinary systematic follow-up of fragility fractures to close the care gap. METHODS: We recruited 543 subjects over 40 years of age who sustained a fragility fracture at the orthopaedic clinic of Hôpital du Sacré-Cœur de Montréal or Hôpital Jean-Talon hospital from July 2010 to 2013. Demographic and clinical data were assessed over 18-months of follow-up. We analysed data of patients who have completed at least 18 months of follow-up (women n=99; men n=16). We described demographic data, BMD, perceived compliance to treatment, and subsequent fracture rates. We assessed the effect on bone markers and vitamin D levels using T-test. RESULTS: Mean age was at 61 years. The common fracture site was the wrist (40%) followed by the ankle and proximal humerus (13%), vertebrae (10%) and hip (7%). Close to 41.7% of women and 20% of men had already sustained a previous fragility fracture. At 18 months, 10.1% of women and 6.3% of men had already sustained a new fracture. High CTX-1 levels (> 0.3 ng/mL) dropped from 46.7% to 21.4% for women and 61.5% to 23.1% for men after 18 months of treatment (p<0.01). Low Vitamin D levels (< 80 nmol/L) increased from 63% to 87.5% for women and 16.7% to 83.3% for men (p<0.00001). Women and men perceived they were still persistent and adherent to treatment at 18 months in 90% and 88% of the time, respectively. CONCLUSIONS: Better diagnostic tools and systematic management of the fragility fractures and compliance monitoring can lower the refracture rates in the long term in this at-risk population.

Conference/Value in Health Info

2014-05, ISPOR 2014, Palais des Congres de Montreal

Value in Health, Vol. 17, No. 3 (May 2014)

Code

PMS84

Topic

Study Approaches

Topic Subcategory

Registries

Disease

Musculoskeletal Disorders

Presentation