Papaioannou A, Giangregorio L, Kvern B, Boulos P, Ioannidis G, Adachi J D
Department of Medicine, McMaster University, Hamilton, Canada.
BMC Musculoskelet Disord. 2004 Apr 6;5:11. doi: 10.1186/1471-2474-5-11.
The presence of a fragility fracture is a major risk factor for osteoporosis, and should be an indicator for osteoporosis diagnosis and therapy. However, the extent to which patients who fracture are assessed and treated for osteoporosis is not clear.
We performed a review of the literature to identify the practice patterns in the diagnosis and treatment of osteoporosis in adults over the age of 40 who experience a fragility fracture in Canada. Searches were performed in MEDLINE (1966 to January 2, 2003) and CINAHL (1982 to February 1, 2003) databases.
There is evidence of a care gap between the occurrence of a fragility fracture and the diagnosis and treatment of osteoporosis in Canada. The proportion of individuals with a fragility fracture who received an osteoporosis diagnostic test or physician diagnosis ranged from 1.7% to 50%. Therapies such as hormone replacement therapy, bisphosphonates or calcitonin were being prescribed to 5.2% to 37.5% of patients. Calcium and vitamin D supplement intake was variable, and ranged between 2.8% to 61.6% of patients.
Many Canadians who experience fragility fracture are not receiving osteoporosis management for the prevention of future fractures.
脆性骨折的出现是骨质疏松症的主要危险因素，应作为骨质疏松症诊断和治疗的指标。然而，骨折患者接受骨质疏松症评估和治疗的程度尚不清楚。
我们对文献进行了综述，以确定加拿大40岁以上经历脆性骨折的成年人骨质疏松症诊断和治疗的实践模式。检索在MEDLINE（1966年至2003年1月2日）和CINAHL（1982年至2003年2月1日）数据库中进行。
有证据表明，在加拿大，脆性骨折的发生与骨质疏松症的诊断和治疗之间存在护理差距。接受骨质疏松症诊断测试或医生诊断的脆性骨折患者比例为1.7%至50%。激素替代疗法、双膦酸盐或降钙素等疗法的处方率为患者的5.2%至37.5%。钙和维生素D补充剂的摄入量各不相同，在患者中的比例为2.8%至61.6%。
许多经历脆性骨折的加拿大人没有接受骨质疏松症管理以预防未来骨折。
