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Conference Paper: A secondary fracture prevention programme to reduce fractures, hospital admissions, and mortality rates at one and five years

TitleA secondary fracture prevention programme to reduce fractures, hospital admissions, and mortality rates at one and five years
Authors
Issue Date2010
PublisherOsteoporosis Society of Hong Kong.
Citation
The 11th Regional Osteoporosis Conference, Hong Kong, 15-16 May, 2010. How to Cite?
AbstractIntroduction: Osteoporosis patients with a prior fracture have a much higher risk of re-fracture. Anti-osteoporosis medications reduce fractures only with prolonged treatment. In 2000, a Secondary Fracture Prevention Programme was piloted in Queen Mary Hospital to evaluate and treat patients with osteoporotic fractures. Objectives: (1) To triage and identify post-fracture patients with good survival and quality of life to minimize unnecessary osteoporosis drug treatment; (2) To reduce re-fractures, (3) To reduce mortality with osteoporosis drug treatment, and (4) To lower cost for hospitals to treat preventable re-fractures. Methodology: Patients with low-traumatic fractures underwent a structured evaluation and triage system for treatment and systematic follow-up programme. The triage was done by a registered nurse in-charged of the programme. Outcome measures included (1) refracture rate; (2) re-admission rate; and (3) mortality rate at 1-, and 5-years using survival analysis. Results: 2,364 fracture patients (1,606 female and 758 male) admitted to Queen Mary Hospital between April 2000 and April 2009 were screened. 1,078 (45.6%) had hip fractures, 565 (23.9%) spine fractures, 31 (13.2%) distal radius fractures and 410 (17.3%) fractures at other sites. 80.2% of patients fulfilled the inclusion criteria and were included into the program. About 80% of these patients were started on anti-osteoporotic medications. The re-fracture rate at 1 and 5 years of patients who received anti-osteoporosis medications were significantly lower than those did not receive medications (both p<0.05). Patients who satisfied the inclusion criteria but did not receive anti-osteoporosis medications had significantly higher re-admission and mortality rates at 1- and 5- years (all p<0.05). Patients who were excluded from the program have significantly lower re-fracture rate but higher mortality rates due to other causes at all time-points (all p<0.05). Anti-osteoporosis medications reduced risk of hip fractures by 88.8%, spine fractures by 88.3%, and other fractures by 82.8% at 12 months. The average cost of bisphosphonates, an effective anti-osteoporosis medication, is $1,400/patient-year. The Hospital Authority Statistical Report for 2007 recorded a total of 25,713 fractures. Based on these data, the secondary fracture prevention programme is estimated to provide a cost-saving of $100,260,300 per year. Conclusion: A structured triage and management programme for secondary fracture prevention was effective in identifying patients with better quality of life who are more likely to benefit from anti-osteoporosis medication, therefore reducing unnecessary drug prescription. Judicial use of anti-osteoporosis agents was effective in reducing re-fractures, and mortality and achieving cost-savings.
DescriptionPoster presentations: Poster 1
Persistent Identifierhttp://hdl.handle.net/10722/126617

 

DC FieldValueLanguage
dc.contributor.authorLoong, CHNen_HK
dc.contributor.authorLeung, Fen_HK
dc.contributor.authorLau, TWen_HK
dc.contributor.authorBow, CHYen_HK
dc.contributor.authorSoong, CSSen_HK
dc.contributor.authorYeung, SSC-
dc.contributor.authorChan, YY-
dc.contributor.authorMa, LF-
dc.contributor.authorLeung, E-
dc.contributor.authorYee, A-
dc.contributor.authorLuk, KDK-
dc.contributor.authorKung, AWC-
dc.date.accessioned2010-10-31T12:38:45Z-
dc.date.available2010-10-31T12:38:45Z-
dc.date.issued2010en_HK
dc.identifier.citationThe 11th Regional Osteoporosis Conference, Hong Kong, 15-16 May, 2010.-
dc.identifier.urihttp://hdl.handle.net/10722/126617-
dc.descriptionPoster presentations: Poster 1-
dc.description.abstractIntroduction: Osteoporosis patients with a prior fracture have a much higher risk of re-fracture. Anti-osteoporosis medications reduce fractures only with prolonged treatment. In 2000, a Secondary Fracture Prevention Programme was piloted in Queen Mary Hospital to evaluate and treat patients with osteoporotic fractures. Objectives: (1) To triage and identify post-fracture patients with good survival and quality of life to minimize unnecessary osteoporosis drug treatment; (2) To reduce re-fractures, (3) To reduce mortality with osteoporosis drug treatment, and (4) To lower cost for hospitals to treat preventable re-fractures. Methodology: Patients with low-traumatic fractures underwent a structured evaluation and triage system for treatment and systematic follow-up programme. The triage was done by a registered nurse in-charged of the programme. Outcome measures included (1) refracture rate; (2) re-admission rate; and (3) mortality rate at 1-, and 5-years using survival analysis. Results: 2,364 fracture patients (1,606 female and 758 male) admitted to Queen Mary Hospital between April 2000 and April 2009 were screened. 1,078 (45.6%) had hip fractures, 565 (23.9%) spine fractures, 31 (13.2%) distal radius fractures and 410 (17.3%) fractures at other sites. 80.2% of patients fulfilled the inclusion criteria and were included into the program. About 80% of these patients were started on anti-osteoporotic medications. The re-fracture rate at 1 and 5 years of patients who received anti-osteoporosis medications were significantly lower than those did not receive medications (both p<0.05). Patients who satisfied the inclusion criteria but did not receive anti-osteoporosis medications had significantly higher re-admission and mortality rates at 1- and 5- years (all p<0.05). Patients who were excluded from the program have significantly lower re-fracture rate but higher mortality rates due to other causes at all time-points (all p<0.05). Anti-osteoporosis medications reduced risk of hip fractures by 88.8%, spine fractures by 88.3%, and other fractures by 82.8% at 12 months. The average cost of bisphosphonates, an effective anti-osteoporosis medication, is $1,400/patient-year. The Hospital Authority Statistical Report for 2007 recorded a total of 25,713 fractures. Based on these data, the secondary fracture prevention programme is estimated to provide a cost-saving of $100,260,300 per year. Conclusion: A structured triage and management programme for secondary fracture prevention was effective in identifying patients with better quality of life who are more likely to benefit from anti-osteoporosis medication, therefore reducing unnecessary drug prescription. Judicial use of anti-osteoporosis agents was effective in reducing re-fractures, and mortality and achieving cost-savings.-
dc.languageengen_HK
dc.publisherOsteoporosis Society of Hong Kong.-
dc.relation.ispartofRegional Osteoporosis Conference-
dc.titleA secondary fracture prevention programme to reduce fractures, hospital admissions, and mortality rates at one and five yearsen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailLeung, F: klleunga@hku.hken_HK
dc.identifier.emailLau, TW: catcher@HKUCC.hku.hken_HK
dc.identifier.emailBow, CHY: corabw@yahoo.comen_HK
dc.identifier.emailSoong, CSS: cissy@hkucc.hku.hk-
dc.identifier.emailYeung, SSC: yeungsc@hkucc.hku.hk-
dc.identifier.emailChan, YY: yychanb@HKUCC.hku.hk-
dc.identifier.emailLuk, KDK: hrmoldk@hkucc.hku.hk-
dc.identifier.emailKung, AWC: awckung@hku.hk-
dc.identifier.hkuros171772en_HK
dc.description.otherThe 11th Regional Osteoporosis Conference, Hong Kong, 15-16 May, 2010.-

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