Fragility Fractures and the Osteoporosis Care Gap: An International Phenomenon
Section snippets
Study Search and Selection
A literature search was conducted in MEDLINE, EMBASE, Cochrane, and CINAHL databases, from 1996 until February 2005. The search strategy included the terms hip fracture [intertrochanteric, subtrochanteric, trochanteric, femoral neck], spinal fractures, vertebral fractures, wrist fractures, osteoporosis [diagnosis, prevention, and control; diet therapy; drug therapy; surgery; therapy], and secondary prevention. Additional articles were identified by consultation with experts and hand searching
Description of Studies
Thirty-five studies met the eligibility criteria (Fig. 1). Three distinct study types were identified (Table 1). Twelve studies investigated diagnosis/treatment outcomes at the time of hospital discharge only (52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63). Three of these studies are listed twice as they examined 2 distinct patient groups (53, 54, 59). Thirteen studies assessed diagnosis/treatment outcomes using an administrative database or from a chart review at a specified time after the
Discussion
The current systematic review provides evidence that individuals in the United Kingdom, New Zealand, Australia, South Africa, Israel, Denmark, France, Canada, the Netherlands, and the United States who experience fragility fracture are not receiving adequate osteoporosis management. Many patients had a history of fracture or went on to experience subsequent fractures. The proportion of patients diagnosed or treated appeared to be greater in follow-up studies than in studies that evaluated
Acknowledgments
This research was supported by a grant-in-aid provided by Merck Frosst. L. Giangregorio is the recipient of a Health Research Partnership Award from the Ontario March of Dimes and the Canadian Institutes of Health Research. A. Cranney holds a research salary award from the Canadian Institutes of Health Research.
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Funding Sources: Grant-in-Aid from Merck Frosst