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澳大利亚初级保健中的骨质疏松症管理。

Management of osteoporosis in primary care in Australia.

机构信息

Institute of Bone & Joint Research, Royal North Shore Hospital, Sydney, Australia.

出版信息

Osteoporos Int. 2009 Mar;20(3):491-6. doi: 10.1007/s00198-008-0686-z. Epub 2008 Jul 17.

DOI:10.1007/s00198-008-0686-z
PMID:18633666
Abstract

UNLABELLED

This study reviewed factors influencing osteoporosis management in primary care settings in Australia and examined risk profiles of patients (n = 37,957) for osteoporosis. Only 29.7% of patients with a prior fracture were currently on specific medication for osteoporosis. The results highlight the need for further exploration of barriers to osteoporosis management.

INTRODUCTION

Osteoporosis management in primary care is suboptimal even for high-risk people with a history of prior fracture.

METHODS

This study reviewed factors influencing the management of individuals at risk for osteoporosis in primary care settings in Australia and examined risk profiles of patients for osteoporosis. Patients (n = 37,957, mean age 71) were recruited over a 12-month period (February 2006-Jan 2007) and interviewed.

RESULTS

With regard to risk factors for osteoporosis, 12.6% of patients reported a history of prior minimal trauma fracture, 7.5% reported a family history of osteoporosis, 7.4% reported they were current smokers, 11.4% reported low dietary calcium intake, 31.8% reported no regular weekly physical exercise and 10.3% reported current use of glucocorticoids. Of those with a prior fracture, only 29.7% were currently on specific medication for osteoporosis. Radiography (n = 17,754) demonstrated a prior vertebral fracture in 30.1%, but only 3.8% of the 17,754 patients reported current use of specific osteoporosis medication.

CONCLUSIONS

This study has confirmed low rates of treatment in primary care even in individuals who have already suffered a prior fracture or have other risk factors. This study highlights the need for further exploration of barriers to osteoporosis management in the primary care setting.

摘要

本研究回顾了澳大利亚初级保健环境中影响骨质疏松症管理的因素,并检查了骨质疏松症患者(n=37957)的风险概况。仅有 29.7%的既往骨折患者目前正在接受特定的骨质疏松症药物治疗。研究结果突出表明,需要进一步探讨初级保健中骨质疏松症管理的障碍。

引言

即使对于有既往骨折史的高危人群,初级保健中的骨质疏松症管理也不尽如人意。

方法

本研究回顾了澳大利亚初级保健环境中影响骨质疏松症高危人群管理的因素,并检查了患者骨质疏松症风险概况。患者(n=37957,平均年龄 71 岁)在 12 个月的时间内(2006 年 2 月至 2007 年 1 月)被招募并接受访谈。

结果

就骨质疏松症的危险因素而言,12.6%的患者报告有既往轻微创伤性骨折史,7.5%报告有骨质疏松症家族史,7.4%报告有吸烟史,11.4%报告低钙饮食摄入,31.8%报告无规律每周体育锻炼,10.3%报告目前正在使用糖皮质激素。在既往骨折患者中,仅有 29.7%目前正在接受特定的骨质疏松症药物治疗。X 光检查(n=17754)显示 30.1%的患者有既往椎体骨折,但在 17754 名患者中,仅有 3.8%报告目前正在使用特定的骨质疏松症药物。

结论

本研究证实,即使在已经遭受既往骨折或有其他危险因素的患者中,初级保健中的治疗率也很低。本研究强调需要进一步探讨初级保健中骨质疏松症管理的障碍。

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CMAJ. 2008 Feb 26;178(5):569-75. doi: 10.1503/cmaj.070981.
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FRAX and the assessment of fracture probability in men and women from the UK.FRAX与英国男性和女性骨折概率评估
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Improving care of patients at-risk for osteoporosis: a randomized controlled trial.
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Integrating post-fracture care into the primary care setting (interFRACT): Protocol for a mixed-methods study to co-design a care program to improve rates of osteoporosis and fracture treatment.将骨折后护理整合到初级保健环境中(interFRACT):一项混合方法研究的方案,旨在共同设计一个护理方案,以提高骨质疏松症和骨折治疗的比率。
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