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MICHAEL WOODHEAD TWO out of three patients with osteoporosis aren’ t receiving treatment despite having obvious risk factors for the condition, according to endocrinologists.

A study of 320 inpatients at St Vincent’ s Hospital in Sydney found that 69 % of those that had been admitted with an osteoporosisrelated condition were not on any osteoporosis medication( not including vitamin D or calcium).

The patients, who were mostly on geriatric and orthopaedic wards, seldom had endocrinology input despite having risk factors, such as a previous fragility fracture or a diagnosis of osteoporosis, according to Dr Angela Sheu and coresearchers at the Garvan Institute’ s Bone Biology Division.

In their one-day bedside audit, they identified 25 %

Not even half of patients identified at high-risk were using osteoporosis medications such as bisphosphonates.

of inpatients as being at high risk of osteoporotic fracture because of previous fracture history or diagnosis of osteoporosis.

However, only 40 % of these patients were using osteoporosis medications, such as bisphosphonates.

Of these, 80 were highrisk patients and 26 had been admitted for a fracture, but only 31 % were on osteoporosis medication.

The endocrinology department had been consulted for fewer than one in four of these patients.

The most common fractures were hip / neck of femur, pelvis, vertebral, humerus and lower leg.

Dr Sheu said the undertreatment of osteoporotic risk factors was an ongoing concern given that the burden of morbidity and mortality from osteoporotic fractures was high.

Patients spent an average of one month in hospital and then faced another 37 days of rehabilitation, she noted.

The 25 % rate of poor bone health was similar to the rate of diabetes among inpatients, and it was unacceptable to have patients untreated, the researchers concluded.

“ More effort is required to identify formally at-risk patients and to ensure that adequate management is instituted to break the cycle of recurrent fractures,” the researchers said. Internal Medicine Journal 2017; online.