Implementation of a mandatory rheumatology osteoporosis consultation in patients with low-impact hip fracture

Quintos-Macasa, Anne-Marie, Quinet, Robert, Spady, Malik, Zakem, Jerald, Davis, William, Menon, Yamini, Serebro, Leonard and Krousel-Wood, M. A. (2007) Implementation of a mandatory rheumatology osteoporosis consultation in patients with low-impact hip fracture. Journal of Clinical Rheumatology, 13 2: 70-72. doi:10.1097/01.rhu.0000260497.84746.dd

Author Quintos-Macasa, Anne-Marie
Quinet, Robert
Spady, Malik
Zakem, Jerald
Davis, William
Menon, Yamini
Serebro, Leonard
Krousel-Wood, M. A.
Title Implementation of a mandatory rheumatology osteoporosis consultation in patients with low-impact hip fracture
Journal name Journal of Clinical Rheumatology   Check publisher's open access policy
ISSN 1076-1608
Publication date 2007-04
Sub-type Article (original research)
DOI 10.1097/01.rhu.0000260497.84746.dd
Volume 13
Issue 2
Start page 70
End page 72
Total pages 3
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Background: Osteoporosis remains an underdiagnosed and undertreated major health problem. The current treatment rate for patients who have experienced at least 1 osteoporotic fracture is 20%–25%. Therefore, the Rheumatology and Internal Medicine Departments of Ochsner Clinic Foundation New Orleans implemented a mandatory rheumatology osteoporosis consult as part of preprinted admission orders for all patients after hip fracture surgery on the Internal Medicine service.

Methods: We conducted a retrospective study of 78 patients admitted with a low-impact hip fracture between June 2004 and July 2005. These patients were seen by the rheumatology service in the hospital after hip fracture repair (exposed group). Osteoporosis evaluation was performed based on an interview questionnaire. Seventy-eight age-matched patients previously admitted for low-intensity or low-impact hip fracture in 2002–2003 but not exposed to the mandatory rheumatology consult served as our comparison group. Pearson [chi]2 test was used for statistical analysis.

Results: Mean patient age was 80 years. Of the 78 unexposed patients, 17 (22%) were on treatment (calcium, vitamin D, hormones or antiresorptive agents) before the hip fracture, and 18 (23%) were on treatment after fracture repair. Of the 78 patients exposed to the compulsory rheumatology consultation, 34 (44%) patients were receiving osteoporosis treatment before hip fracture and 75 (96%) patients were receiving treatment after fracture repair. Of the patients not treated before hip fracture repair, there was a significant increase in the percent treated for those patients exposed to the rheumatology consult versus those not exposed (97.6% vs. 2.4%, respectively, P < 0.0001).

Conclusions: In our institution, we were successful in identifying and initiating appropriate therapy for osteoporosis patients through an automatic rheumatology osteoporosis consultation after hip fracture. The implementation of a mandatory osteoporosis consult resulted in a statistically significant increase in treatment of the exposed group compared with the unexposed group.
Keyword Osteoporosis
Hip Fracture
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 13 times in Scopus Article | Citations
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Created: Mon, 14 Mar 2011, 09:58:23 EST