Screening for osteoporosis reduced new fracture incidence by almost half

Abstract

Background and purpose Fractures can be prevented if osteoporosis is identified and treated. In 2002, we initiated a screening program at our orthopedics department, in which patients between 50 and 75 years of age with a wrist, shoulder, vertebral, or hip fracture are assessed by DEXA of the hip and spine and encouraged to see their doctor for decision on treatment regarding osteoporosis. The patients receive written documents containing information, DEXA results, and a letter to their doctor with suggestions regarding blood tests and treatment. In this 6-year follow-up study, we compared the fracture recurrence in 2 groups: patients screened for osteoporosis after fracture as described, and a historical control group with fracture patients who presented at our department 1 year before we started the screening intervention.

Methods A questionnaire was sent to the 2 groups of fracture patients, those from before the time that we started the screening in 2002 and those who participated in the initial screening study in 2003. The questionnaire included questions on whether they had sustained further fractures, whether they had seen a doctor, and whether treatment had been initiated.

Results 239 of the 306 unscreened patients (68%) and 219 of the 286 screened patients (77%) answered the questionnaire. In the unscreened group, 69 new fractures had occurred, in contrast to 39 in the screened group. The fracture risk was 42% lower in the screened group. Answers regarding treatment were incomplete in the unscreened group.

Interpretation Screening of fracture patients for osteoporosis reduced fracture recurrence, which indicates that the screening procedure has resulted in treatment that prevents fractures.

JÅ: study concept and design; acquisition, analysis, and interpretation of the data; and drafting of the manuscript. JN and KGT: critical review of the manuscript.

We thank Ulla-Britt Ohlsson and Ann-Christin Sörensen for identifying patients and taking care of correspondence, and Alexandra Turkiewicz for statistical analysis.

JÅ and KGT have received speaker’s fees from Aventis and MSD.