Improving the Pharmacologic Management of Patients after Osteoporotic Hip Fractures

Abstract

Background Osteoporotic hip fractures have become an increasingly common healthcare burden with significant morbidity and mortality in the geriatric population. Pharmacological management of the underlying osteoporosis is critical. Our objective is to determine the percentage of patients older than 65 who receive pharmacologic treatment of osteoporosis within six months after a fragility fracture at Cabell Huntington Hospital. Methods Data was extracted from medical records for patients age 65 or older who sustained a hip fracture during June 2013 - March 2015. Patients who received any form of pharmacologic treatment within six months after their fractures were identified. All analyses were performed using SAS version 9.3 (SAS Institute, Cary, North Carolina). Results Among the 193 patients who met the inclusion criteria, 26% (n=50) received pharmacologic treatment within six months after fracturing versus 74% (n=143) who did not receive any type of pharmacologic therapy after the fracture. Female was the predominant gender in pharmacologic treatment group (74% vs 71%). Mean age was 81 years old in both groups (81±9 vs 82±8), mean BMI was 25 in both groups (25±5 vs 25±6). There was no significant difference in pharmacologic management when the patients were stratified according to age group. Conclusion Patients were pharmacologically undertreated after an osteoporotic hip fracture, regardless of the age of fracture presentation. Due to potential benefits of pharmacologic treatment after osteoporotic hip fracture, treatment should be initiated prior to discharge, if possible. If this is not feasible for the patient, specific and detailed instructions should be given to the patient’s primary care physician, or endocrinologist if medically complicated, for initiating therapy and proper management of the patient.

Keywords

• Osteoporosis
• Hip fracture
• Geriatrics
• FRAX
• PTAF
• Pharmacologic management of fractures