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. 2018;26(6):384-387.
doi: 10.1590/1413-785220182606202125.

ARE TRAUMATOLOGISTS TREATING OSTEOPOROSIS TO PREVENT NEW FRACTURES IN BRAZIL?

Caio Zamboni  1 , Marina Sousa Carvalho  1 , Eduardo Araujo Pires  1 , Jorge Rafael Durigan  1 , Patrícia Maria de Moraes Barros Fucs  1 , Marcelo Tomanik Mercadante  1
Affiliations

ARE TRAUMATOLOGISTS TREATING OSTEOPOROSIS TO PREVENT NEW FRACTURES IN BRAZIL?

Caio Zamboni et al. Acta Ortop Bras. 2018.

Abstract
in English, Portuguese

Objectives: To determine the proportion of traumatologists who investigate osteoporosis in elderly patients with fractures and recommend secondary prevention of osteoporotic fractures.

Methods: We distributed questionnaires to 244 physicians attending the 2015 Brazilian Congress of Orthopedic Trauma. We determined the respondents' profiles and assessed how they investigated and treated osteoporosis in elderly patients with fractures.

Results: Overall, 32% of the respondents reported that their knowledge level regarding osteoporosis ranged from 0-5 (out of 0-10). In total, 42% of the participants reported that they usually requested DXA for elderly patients with fractures and less than 30% reported prescribing supplemental calcium and/or vitamin D. We considered physicians conducting a complete treatment for the patient as those who in addition to requesting DXA prescribed supplemental calcium, vitamin D, and specific medications for their elderly patients, and recommended non-pharmacological measures. Only 0.8% of the participants fulfilled all these criteria. In addition, 47% of the traumatologists reported that they did not treat osteoporosis directly but instead, referred osteoporotic patients to a qualified physician.

Conclusion: Less than 50% of the surveyed traumatologists investigated and performed secondary prevention against osteoporotic fractures after treating an elderly patient with a fracture. Level of evidence III, Economic and Decision Analyses - Developing an Economic or Decisions Model.

Objetivo: Avaliar a proporção de traumatologistas que investigam a osteoporose nos pacientes idosos com fraturas e recomendam a prevenção secundária das fraturas osteoporóticas.

Métodos: Distribuímos questionários para 244 médicos participantes do Congresso Brasileiro de Traumatología Ortopédica em 2015. Determinamos o perfil dos mesmos e avaliamos como os entrevistados investigam e tratam a osteoporose nos pacientes idosos com fraturas.

Resultados: Entre os entrevistados, 32% relataram que seu nível de conhecimento sobre osteoporose seria algo entre 0 e 5 (de 0 a 10). No total, 42% dos participantes relataram que frequentemente solicitam DXA para pacientes idosos com fraturas, mas menos de 30% relataram prescrever suplementação com cálcio e/ou vitamina D. Consideramos como prescritores do tratamento completo para o paciente aqueles médicos que, além de solicitar DXA, prescrevem suplementação de cálcio, vitamina D e medicamentos específicos para seus pacientes idosos, além de recomendar medidas não farmacológicas. Apenas 0,8% dos participantes preencheram todos esses critérios. Além disso, 47% dos traumatologistas relataram que não tratam a osteoporose, mas encaminham seus pacientes com osteoporose para um médico que o faz.

Conclusão: Menos de 50% dos traumatologistas pesquisados investigam e realizam prevenção secundária contra fraturas osteoporóticas após tratamento de paciente idoso com fratura. Nível de evidência III, Análises econômicas e de decisão - Desenvolvimento de modelo econômico ou de decisão.

Keywords: Osteoporosis; Osteoporotic Fracture; Secondary Prevention; Surveys and Questionnaires.

PubMed Disclaimer

Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. Percentages of physicians who conduct a complete treatment of osteoporosis. Among all participants, the percentages of those who request DXA (DXA), also knows the correct T-score cutoff value (DXA + T-score), also prescribes supplemental calcium and vitamin D (DXA + T-score + Ca + Vit D), also prescribes specific medications (DXA + T-score + Ca + Vit D + Sp Med [antiresorptive or bone forming agents]), and also recommends non-pharmacological measures to their patients (DXA + T-score + Ca + Vit D + Sp Med + Recomm).
Figure 2
Figure 2. Distribution of follow-up scenarios according to the duration of orthopedics practice. The bars show the percentages of participants who reported requesting DXA (DXA), knowing the correct T-score to establish a diagnosis of osteoporosis (T-score); recommending supplemental calcium and vitamin D (Ca + Vit D), prescribing specific medications for osteoporosis (Spec Med), recommending non-pharmacological measures (Recomm), and referring the patient when not performing treatment (Referr).
See this image and copyright information in PMC

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