Fragility Fracture Prevention Treatment in a Continued Care Facility: An Opportunity for Intervention

• Autor(a) principal: Saraiva, André Pinto; Serviço de Medicina Física e de Reabilitação Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
• Data de Publicação: 2023
• Outros Autores: Moreira, Sofia Sousa; Centro de Medicina de Reabilitação da Região Centro Rovisco Pais, Paiva, Carolina; Centro de Medicina de Reabilitação da Região Centro Rovisco Pais, Tocha, Portugal, Peixoto, Pedro Alves; Departamento de Psiquiatria e Saúde Mental - Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal, Laíns, Jorge; Serviço de Medicina Física e de Reabilitação Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.25759/spmfr.484
• topic: osteoporosis; frail elderly; bone fractures; rehabilitation; patient care; Assistência de Longa Duração; Fraturas Ósseas/reabilitação; Fraturas por Osteoporose; Idosos Frágeis; Osteoporose/reabilitação

Introduction: Fragility fractures occur spontaneously or after minor trauma. They are common in frail patients and are associated with increased disability, morbidity and mortality. Fragility fractures account for a considerable number of admissions in continued care facilities, representing a major economic burden. Our aim was to evaluate whether patients admitted to a continued care facility with a fragility fracture diagnosis have received adequate treatment to prevent new fractures.Methods: This is a retrospective cohort study conducted at Unidade de Cuidados Continuados de Convalescença Rovisco Pais. All patients admitted from July 2021 to August 2022 with a fragility fracture were included.Results: Eighty eight patients were included (mean age 85±8.71 years; female 76.2%; average length of stay 60±25.8 days; proximal femur fracture 91.3%, vertebral fractures 8.8%). At the time of discharge, 16 (2.6%) had been prescribed antiresorptive drugs; 15 (20.5%) received vitamin D and only 2 (2.7%) had been prescribed calcium. Six (7.5%) had a subsequent fracture. Frail patients were older, had more falls and were more likely to have an adverse event during stay.Conclusion: Although all patients had indication for treatment with antiresorptive drugs, and despite the availability of effective pharmacologic interventions and well- established guidelines for fracture prevention, only a minority received such treatment. These findings support that there is clear room for improvement and this study sets the pace for developing an intervention protocol.