Management of Osteoporosis in The Community: How Well Can Family Physicians Do? A Retrospective Case Series in a Local Public Clinic in Hong Kong.
Background
With the ageing population, osteoporosis is increasingly becoming a global health concern. Previous research showed that management of osteoporosis in Hong Kong had been suboptimal. In view of the need to provide quality care to osteoporotic patients, a Multidisciplinary Osteoporosis Clinic (MOC) organized by primary care physicians was set up in a public primary care clinic. This study aimed to explore the clinical effectiveness of MOC.
Methods
We performed a retrospective case series study. All osteoporotic patients who had attended MOC during the period 1 January 2015 to 31 December 2018 were included. Changes in Dual X-ray absorptiometry (DEXA) T-score of recruited patients after two years of management at MOC were analysed. Subgroup analyses of the 2-year interval DEXA T-score changes among patient with or without history of fragility fracture, and among patients with or without pharmacological treatment , were performed. Serial interval DEXA T-score changes of recruited patients who had completed 5 years of bisphosphonate treatment were also analysed. Paired Student’s t test was used to analyze the interval DEXA T-score changes.
Results
Totally 186 osteoporotic patients were recruited. After two years of management at MOC, the T-score at lumbar spine and femoral neck were improved, from -2.71±0.76 to -2.35±0.83 and -2.40±0.75 to -2.10±0.76 respectively, P<0.001. For subgroup analysis on patients with or without history of fragility fracture and patients with or without bisphosphonate treatment, improvement in T-scores of both lumbar and femoral neck were all significant at two years, P<0.05.
Among those who had completed 5 years of bisphosphonate treatment, progressive improvement in T-scores of both lumbar and femoral neck were observed, with P <0.001.
Conclusion
MOC run by family physicians in public primary care setting could effectively treat osteoporotic patients with significant improvement in DEXA T-scores.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Posted 31 Dec, 2020
Invitations sent on 13 Jan, 2021
On 11 Jan, 2021
On 28 Dec, 2020
On 28 Dec, 2020
On 22 Dec, 2020
Management of Osteoporosis in The Community: How Well Can Family Physicians Do? A Retrospective Case Series in a Local Public Clinic in Hong Kong.
Posted 31 Dec, 2020
Invitations sent on 13 Jan, 2021
On 11 Jan, 2021
On 28 Dec, 2020
On 28 Dec, 2020
On 22 Dec, 2020
Background
With the ageing population, osteoporosis is increasingly becoming a global health concern. Previous research showed that management of osteoporosis in Hong Kong had been suboptimal. In view of the need to provide quality care to osteoporotic patients, a Multidisciplinary Osteoporosis Clinic (MOC) organized by primary care physicians was set up in a public primary care clinic. This study aimed to explore the clinical effectiveness of MOC.
Methods
We performed a retrospective case series study. All osteoporotic patients who had attended MOC during the period 1 January 2015 to 31 December 2018 were included. Changes in Dual X-ray absorptiometry (DEXA) T-score of recruited patients after two years of management at MOC were analysed. Subgroup analyses of the 2-year interval DEXA T-score changes among patient with or without history of fragility fracture, and among patients with or without pharmacological treatment , were performed. Serial interval DEXA T-score changes of recruited patients who had completed 5 years of bisphosphonate treatment were also analysed. Paired Student’s t test was used to analyze the interval DEXA T-score changes.
Results
Totally 186 osteoporotic patients were recruited. After two years of management at MOC, the T-score at lumbar spine and femoral neck were improved, from -2.71±0.76 to -2.35±0.83 and -2.40±0.75 to -2.10±0.76 respectively, P<0.001. For subgroup analysis on patients with or without history of fragility fracture and patients with or without bisphosphonate treatment, improvement in T-scores of both lumbar and femoral neck were all significant at two years, P<0.05.
Among those who had completed 5 years of bisphosphonate treatment, progressive improvement in T-scores of both lumbar and femoral neck were observed, with P <0.001.
Conclusion
MOC run by family physicians in public primary care setting could effectively treat osteoporotic patients with significant improvement in DEXA T-scores.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5