Daniel Martínez-Laguna, Cristina Carbonell Abella, José-Carlos Bastida, Milagros González, Rafael M Micó-Pérez, Francisco Vargas, Eva Díaz Torres, Laura Canals
{"title":"西班牙初级保健中的二次骨折预防：PREFRAOS 研究结果。","authors":"Daniel Martínez-Laguna, Cristina Carbonell Abella, José-Carlos Bastida, Milagros González, Rafael M Micó-Pérez, Francisco Vargas, Eva Díaz Torres, Laura Canals","doi":"10.1007/s11657-024-01394-3","DOIUrl":null,"url":null,"abstract":"<p><p>This study demonstrated a large treatment gap in elderly subjects experiencing fragility fracture in Spanish primary care, a low treatment persistence among subjects who do receive treatment, and more than one-quarter having no follow-up visits post-fracture. These data highlight the need to improve secondary fracture prevention in primary care.</p><p><strong>Purpose: </strong>To describe osteoporosis (OP) treatment patterns and follow-up in subjects with fragility fracture seen in Spanish primary care (PC).</p><p><strong>Methods: </strong>This observational, retrospective chart review included subjects aged ≥ 70 years listed in the centers' records (November 2018 to March 2020), with ≥ 1 fragility fracture and prior consultation for any reason; subjects who had participated in another study were excluded. Outcomes included OP treatments and follow-up visits post-fragility fracture.</p><p><strong>Results: </strong>Of 665 subjects included, most (87%) were women; overall mean (SD) age, 82 years. Fewer than two thirds (61%) had received any prior OP treatment (women, 65%; men, 38%); of these, 38% had received > 1 treatment (women, 25%; men, 13%). Among treated subjects, the most frequent first-line treatments were alendronate (43%) and RANKL inhibitor denosumab (22%), with a higher discontinuation rate and shorter treatment duration observed for alendronate (discontinuation, 42% vs 16%; median treatment duration, 2.5 vs 2.1 years). Over one-quarter (26%) of subjects had no follow-up visits post-fragility fracture, with this gap higher in women than men (35% versus 25%). The most common schedule of follow-up visits was yearly (43% of subjects with a fragility fracture), followed by half-yearly (17%) and biennial (10%), with a similar trend in men and women. Most OP treatments were prescribed by PC physicians, other than teriparatide and zoledronate.</p><p><strong>Conclusions: </strong>Across Spanish PC, we observed a large gap in the treatment and follow-up of elderly subjects experiencing a fragility fracture. Our data highlights the urgent need to improve secondary fracture prevention in PC.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081989/pdf/","citationCount":"0","resultStr":"{\"title\":\"Secondary fracture prevention in Spanish primary care: results of the PREFRAOS Study.\",\"authors\":\"Daniel Martínez-Laguna, Cristina Carbonell Abella, José-Carlos Bastida, Milagros González, Rafael M Micó-Pérez, Francisco Vargas, Eva Díaz Torres, Laura Canals\",\"doi\":\"10.1007/s11657-024-01394-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>This study demonstrated a large treatment gap in elderly subjects experiencing fragility fracture in Spanish primary care, a low treatment persistence among subjects who do receive treatment, and more than one-quarter having no follow-up visits post-fracture. These data highlight the need to improve secondary fracture prevention in primary care.</p><p><strong>Purpose: </strong>To describe osteoporosis (OP) treatment patterns and follow-up in subjects with fragility fracture seen in Spanish primary care (PC).</p><p><strong>Methods: </strong>This observational, retrospective chart review included subjects aged ≥ 70 years listed in the centers' records (November 2018 to March 2020), with ≥ 1 fragility fracture and prior consultation for any reason; subjects who had participated in another study were excluded. Outcomes included OP treatments and follow-up visits post-fragility fracture.</p><p><strong>Results: </strong>Of 665 subjects included, most (87%) were women; overall mean (SD) age, 82 years. Fewer than two thirds (61%) had received any prior OP treatment (women, 65%; men, 38%); of these, 38% had received > 1 treatment (women, 25%; men, 13%). Among treated subjects, the most frequent first-line treatments were alendronate (43%) and RANKL inhibitor denosumab (22%), with a higher discontinuation rate and shorter treatment duration observed for alendronate (discontinuation, 42% vs 16%; median treatment duration, 2.5 vs 2.1 years). Over one-quarter (26%) of subjects had no follow-up visits post-fragility fracture, with this gap higher in women than men (35% versus 25%). The most common schedule of follow-up visits was yearly (43% of subjects with a fragility fracture), followed by half-yearly (17%) and biennial (10%), with a similar trend in men and women. Most OP treatments were prescribed by PC physicians, other than teriparatide and zoledronate.</p><p><strong>Conclusions: </strong>Across Spanish PC, we observed a large gap in the treatment and follow-up of elderly subjects experiencing a fragility fracture. Our data highlights the urgent need to improve secondary fracture prevention in PC.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11081989/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11657-024-01394-3\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11657-024-01394-3","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
引用次数: 0
摘要
这项研究表明，在西班牙初级医疗机构就诊的脆性骨折老年患者中，存在很大的治疗缺口，接受治疗的患者中治疗持续率较低，超过四分之一的患者在骨折后没有进行随访。目的：描述西班牙初级医疗机构（PC）中脆性骨折患者的骨质疏松症（OP）治疗模式和随访情况：这项观察性、回顾性病历审查纳入了中心记录中年龄≥70岁（2018年11月至2020年3月）、脆性骨折≥1次且之前因任何原因就诊过的受试者；排除了参与过其他研究的受试者。结果包括OP治疗和脆性骨折后的随访：在纳入的 665 名受试者中，大多数（87%）为女性；总平均（标清）年龄为 82 岁。不到三分之二（61%）的受试者之前接受过任何 OP 治疗（女性 65%；男性 38%）；其中 38% 的受试者接受过一次以上的治疗（女性 25%；男性 13%）。在接受治疗的受试者中，最常见的一线治疗是阿仑膦酸钠（43%）和RANKL抑制剂地诺单抗（22%），阿仑膦酸钠的停药率较高，治疗时间较短（停药率为42%对16%；中位治疗时间为2.5年对2.1年）。超过四分之一（26%）的受试者在脆性骨折后没有进行随访，女性的这一比例高于男性（35% 对 25%）。最常见的随访时间是每年一次（43% 的脆性骨折患者），其次是半年一次（17%）和两年一次（10%），男性和女性的趋势相似。除特立帕肽和唑来膦酸钠外，大多数 OP 治疗均由 PC 医生处方：在西班牙的所有 PC 中，我们发现在对发生脆性骨折的老年人进行治疗和随访方面存在很大差距。我们的数据凸显了改善PC二级骨折预防的迫切性。
Secondary fracture prevention in Spanish primary care: results of the PREFRAOS Study.
This study demonstrated a large treatment gap in elderly subjects experiencing fragility fracture in Spanish primary care, a low treatment persistence among subjects who do receive treatment, and more than one-quarter having no follow-up visits post-fracture. These data highlight the need to improve secondary fracture prevention in primary care.
Purpose: To describe osteoporosis (OP) treatment patterns and follow-up in subjects with fragility fracture seen in Spanish primary care (PC).
Methods: This observational, retrospective chart review included subjects aged ≥ 70 years listed in the centers' records (November 2018 to March 2020), with ≥ 1 fragility fracture and prior consultation for any reason; subjects who had participated in another study were excluded. Outcomes included OP treatments and follow-up visits post-fragility fracture.
Results: Of 665 subjects included, most (87%) were women; overall mean (SD) age, 82 years. Fewer than two thirds (61%) had received any prior OP treatment (women, 65%; men, 38%); of these, 38% had received > 1 treatment (women, 25%; men, 13%). Among treated subjects, the most frequent first-line treatments were alendronate (43%) and RANKL inhibitor denosumab (22%), with a higher discontinuation rate and shorter treatment duration observed for alendronate (discontinuation, 42% vs 16%; median treatment duration, 2.5 vs 2.1 years). Over one-quarter (26%) of subjects had no follow-up visits post-fragility fracture, with this gap higher in women than men (35% versus 25%). The most common schedule of follow-up visits was yearly (43% of subjects with a fragility fracture), followed by half-yearly (17%) and biennial (10%), with a similar trend in men and women. Most OP treatments were prescribed by PC physicians, other than teriparatide and zoledronate.
Conclusions: Across Spanish PC, we observed a large gap in the treatment and follow-up of elderly subjects experiencing a fragility fracture. Our data highlights the urgent need to improve secondary fracture prevention in PC.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
