The Second Fracture can be prevented. How? Realize that your first fracture is a “Bone Attack” – a warning to start working on your Bone Health.
The National Osteoporosis Foundation (NOF) 2014 meeting focused on identifying first fractures and preventing second fractures. Someone who has fractured once is 2 to 5 times as likely to fracture (again) than a person who has not fractured. If DXA and T-score are in “normal” or “osteopenia” range, we have to look deeper. A Complete Bone Health Evaluation is often needed to find the issues that can be corrected.
The NOF sessions analyzed systems which have worked well to decrease fractures. Hip fractures are the main focus because they are so often life changing or even life ending. We all know individuals who cannot care for themselves or live independently after a hip fracture. We can prevent that misery.
Kaiser and Geisinger are both HMO’s with fully integrated health systems. They are paid based on the numbers of patients they are responsible for. The fewer fractures their members have, the less they spend caring for fractures, the more can be devoted to other services their members desire. Since 2000 they have decreased the rate of hip fractures by more than half. Representatives of both systems shared the basic methods which have worked for them.
The key is to treat every fracture as a “Bone Attack” and fully evaluate the bone health of every fracture patient. That is what we offer at Cedar Valley Bone Health Institute of Iowa. At this national meeting, we shared some of our methods. We also learned new ways to improve on our services. More next time.
Jay Ginther, MD