Nov 3 2008
A study conducted by Kaiser Permanente Southern California has shown that proactive measures can reduce hip fracture rates by an average of 37.2 percent -- and as much as 50 percent -- among those at risk. The study was published online on November 3 by The Journal of Bone & Joint Surgery, a peer-reviewed journal.
The five-year study led by Richard M. Dell, MD, an orthopedic surgeon at the Kaiser Permanente Bellflower Medical Center, tracked more than 625,000 male and female patients over the age of 50 in Southern California who had specific risk factors for osteoporosis and/or hip fractures. The implementation of a number of initiatives in the Kaiser Permanente Southern California Healthy Bones Program reduced the hip fracture rates well beyond the goal rate of 25 percent.
“One-half of all women and one-third of all men will sustain a fragility fracture in their lifetime. The mortality rate due to osteoporosis-related fractures is greater than the rates for breast cancer and cervical cancer combined,” notes Dell. “I’d like to dispel the misconception that nothing can be done to prevent or treat osteoporosis. It is possible to achieve at least a 25 percent reduction in the hip fracture rate in the United States if a more active role is taken by all orthopedic surgeons in osteoporosis disease management. We’ve seen it; we’ve done it.”
Participating physicians implemented a number of initiatives including increasing the use of bone density test (DXA Scans) and anti-osteoporosis medications; adding osteoporosis education and home health programs; and standardizing the practice guidelines for osteoporosis management. The full article is found at www.ejbjs.org/cgi/content/abstract/90/Supplement_4/188
The National Osteoporosis Foundation reports that, although osteoporosis can affect people of all ages, the problem of osteoporosis has reached epidemic proportions with the rapidly aging population. Of the 10 million Americans who have osteoporosis, 80 percent are women. More than 300,000 hip fractures are reported annually in the United States. Twenty-four percent end up in a nursing home, fifty percent never reach their functional capacity, and twenty-five percent of patients with a hip fracture die in the first year after the incident.
“We realize that Kaiser Permanente has a significant advantage in osteoporosis disease management. We have an integrated healthcare delivery program with an advanced electronic medical record that allows for identification, risk stratification, and tracking of our patients,” said Dell. “Kaiser Permanente also has the advantage of care managers that use our information systems to help manage and treat our patients with osteoporosis.”
“Nonetheless, significant improvements are achievable wherever orthopedic surgeons and treatment teams are willing to take a more active role in osteoporosis disease management.”