Background Osteoporosis represents a major public health problem due to the seriousness of a patient's main complication: fracture. The lack of the Colombian health system for a structured public policy aiming diagnosis and early intervention generates a high volume of patients having fragility fractures.
Objectives To describe the clinical and demographic characteristics of patients with fragility fractures seen in our hospital. To describe the risk factors for fragility fractures. To inquire about the patient's knowledge about osteoporosis. To follow each case establishing whether after presenting the complication (fracture), the patient would receive an ambulatory treatment covered by the health insurance.
Methods Cross-sectional descriptive study
Results 111 patients mean age of 74.4 years (± 11.3 years), 84 (75.6%) were women. All consulted for osteoporotic fracture. The most frequent type of fracture was hip (51.4%), followed by vertebra (23.4%), wrist (22.5%) and humerus (4.5%). 87.4% (n=97) had no personal history of fracture and only 1% had a history of frailty fracture in a first-degree relative. Risk factors: 7.2% (n=8) used glucocorticoids, 3.6% (n=4) antiepileptics and 3.6% (n=4) warfarin. 21.6% (n=24) were smokers. 77.5% (n=86) had never previously undergone a densitometry despite the fact that, because of their age, they had indicated that this study had previously been performed. Knowledge of osteoporosis by patients: 49.5% (n=55) did not know that osteoporosis was present, 58.6% (n=65) did not know that fracture was the main complication of this disease and 62.2% =69) does not relate to fractures with osteoporosis. All patients were educated and sensitized about osteoporosis and the importance of diagnosis and treatment and they were given an order to perform densitometry at discharge, despite the above 24.3% (n=27) densitometry was performed in the next year of the fracture. As for treatment, 33.3% (n=37) received calcium plus vitamin D. Only 9.9% (n=11) received treatment for osteoporosis (7 patients with bisphosphonate and 4 with denosumab), none received teriparatide osteoformer therapy.
Conclusions The present study demonstrates the lack of understanding by the Colombian patients about osteoporosis. Despite of clear indications described international guidelines, we have found a the lack of densitometry measurements on our follow up patients. More serious, only 10% of the patients received treatment for osteoporosis and none of them used a osteoformer therapy. This proves the suboptimal follow-up made by the health insurance companies of our country. Urgent educational and public health policies are needed.
Disclosure of Interest None declared