Medical Inspection – Health Blog

Over the study period, 59 patient charts were reviewed for eligibility. Twenty-two patients were excluded because of traumatic or pathological fracture, age less than 45 years, or cognitive impairment without a caregiver to receive the intervention on their behalf. Of the 37 eligible patients, 23 (62%) provided consent to participate. Follow-up was completed for all of these patients, but one patient declined to answer the follow- up OPQ.

Demographic DataThe patients’ characteristics are presented in Table 1. All of the patients were white, most were female (83%), and all of the female patients were post­menopausal. The mean weight was 70.8 kg (range 45.5 to 105 kg, SD 16.9) and the mean height 164.9 cm (range 147.3 to 187.9 cm, SD 10.6). Body mass index ranged from 17.5 to 37.5 kg/m2 (mean 26.0, SD 5.5). Two patients (9%) had a prior diagnosis of osteoporo­sis, and 8 (35%) had had at least one previous fracture, not necessarily a fragility fracture. Details of previous fractures and current fragility fractures are given in Table 1. Eighteen patients (78%) were taking medications that could increase their propensity to fall (antihyperten- sives, narcotic analgesics, anticholinergics, sedatives).

Primary Outcomes

By virtue of their fragility fractures occurring after age 40 (the inclusion criteria for this study), all of the patients had at least one major risk factor for osteoporosis. At baseline, 6 patients (26%) had 2 or 3 risk factors and 17 (74%) had 4 or more risk factors (Table 2), as defined by the 2002 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis. One person who had 6 risk factors at baseline had 7 risk factors at follow-up because calcium intake fell below the recommended daily amount. Another patient had 2 risk factors at baseline but only 1 risk factor at follow-up because calcium intake had increased to the recommended daily amount. The mean number of risk factors was 4.0 at baseline and 3.8 at follow-up (Table 2) (p = 0.30).
levitra plus

At baseline, 7 patients (30%) were consuming at least the recommended daily intake of calcium(> 1500 mg/day) from diet and supplements, and 5 (22%) patients were consuming the equivalent amount at follow-up (p = 0.62). At baseline, the mean total daily calcium was 1085.9 mg (range 0 to 3050 mg) and the mean dietary calcium was 802.4 mg (range 0 to 2550 mg). At follow-up, the mean total daily calcium was 1173.6 mg (range 300 to 2699 mg) and the mean dietary calcium intake was 855.3 mg (range 150 to 1671 mg). Even though 2 patients had dropped below the thresh­old of recommended daily intake, the mean total and mean dietary calcium intake increased overall. However, neither was statistically significant (p = 0.58 and p = 0.70, respectively).

Table 1. Baseline Characteristics of Patients Seen at Kingston General Hospital for Fragility Fracture (n = 23)

At baseline, 3 (13%) of the patients were consuming 800 units or more of vitamin D as supplements. At follow-up, 2 of the patients who had been taking less than 800 units per day at baseline had increased their vitamin D supplementation to 800 units or more per day, but one patient who had been taking at least 800 units at baseline had dropped below this level at follow-up. In total, 4 (17%) of the patients were consuming 800 units of vitamin D supplementation at follow-up. The mean total daily vitamin D was 243.5 units at baseline and 861.4 units at follow-up (p = 0.14).
canadian cialis

Five (22%) of the patients were smokers at baseline. None of these smokers had quit by the time of follow-up.
Six (26%) of the patients, classified as heavy caffeine consumers, had an intake of caffeine equivalent to 4 or more cups of coffee per day at baseline, but only 2 (9%) of the patients had this level of caffeine intake at follow-up (p = 0.06).

Table 2. Risk Factors for Osteoporosis (n = 23)

The mean number of alcoholic drinks per week decreased from 0.87 (range 0 to 14) at baseline to 0.22 (range 0 to 2) at follow-up. This decline was not sta­tistically significant (p = 0.23) primarily because a large proportion of patients did not drink at either time point.

At both baseline and follow-up, 1 patient (4%) had been receiving systemic glucocorticoid therapy for more than 3 months and 1 patient (4%) was receiving long- term anticonvulsant therapy. The first of these 2 patients saw her physician after discharge and discussed osteo­porosis, but no plans were made for a BMD scan. The other patient did not see her doctor after the fracture, and no plans were in place at the time of follow-up to assess for osteoporosis. eriacta

Related Posts:

• Results of Patient Education about Osteoporosis after Fragility Fracture: DISCUSSION
• Results of Patient Education about Osteoporosis after Fragility Fracture: Osteoporosis Knowledge
• Results of Patient Education about Osteoporosis after Fragility Fracture: Outcome Measures
• Results of Patient Education about Osteoporosis after Fragility Fracture: Pharmacist’s Role