Objective:

To evaluate the guideline concordance of osteoporosis therapy in patients admitted with hip fractures and quantify the prevalence of medications associated with increased fall and fracture risk at the time of hospital admission.

Approach:

• Study Design: A prospective observational study conducted at a tertiary academic trauma center over three months, assessing pre-fracture osteoporosis management.
• Patient Population: Patients aged 55 years or older with low-energy femoral fractures were included, while those without complete pre-admission medication data were excluded.
• Data Collection: Pre-admission medication was assessed through structured medication reconciliation, including medical records and patient interviews.
• Assessment of Treatment: Guideline concordance was evaluated based on the Austrian Society for Bone and Mineral Metabolism guidelines, considering documented osteoporosis diagnoses or high fracture risk.

Key Findings:

• Significant care gaps exist in osteoporosis treatment following hip fractures.
• Many patients remain untreated despite clear indications for pharmacological therapy.
• Medication-related risk factors, particularly fall-risk-increasing drugs, contribute to fracture risk.

Interpretation:

The study evaluates the guideline concordance of osteoporosis therapy and the prevalence of medications associated with increased fall and fracture risk in patients with hip fractures.

Limitations:

• The study only included patients from a single tertiary center, which may limit generalizability.
• Data on pre-fracture medication profiles may not capture all relevant prescribing patterns.

Conclusion:

The study highlights the need for timely intervention in osteoporosis management and medication review to prevent hip fractures.

Sources:

• Austrian osteoporosis guideline