Characterisation of Patients with Postmenopausal Osteoporosis in French Primary Healthcare
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ORIGINAL RESEARCH ARTICLE
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Characterisation of Patients with Postmenopausal Osteoporosis in French Primary Healthcare Francis Blotman,1 Bernard Cortet,2 Pascal Hilliquin,3 Bernard Avouac,4 Fran¸coisAndr´e Allaert,5 Denis Pouchain,6 Anne-Fran¸coise Gaudin,7 Fran¸cois-Emery Cott´e7 and Abdelkader El Hasnaoui7 1 2 3 4 5 6 7
Rheumatology Department, Montpellier University Hospital, Montpellier, France ˆ Rheumatology Department, Hopital Roger Salengro, Lille, France Rheumatology Department, Sud Francilien Hospital, Corbeil-Essonne, France OFOS (Observatoire Fran¸cais pour l’Ost´eoporose), Paris, France Biostatistics Department, Cenbiotech, Regional University Hospital, Dijon, France General Practice Department, UFR Cr´eteil, Cr´eteil, France GlaxoSmithKline Laboratory, Marly-le-Roi, France
Abstract
Background: The public health burden of osteoporosis is high, principally because of increased risk of fractures and associated morbidity, handicap and mortality. Osteoporotic fracture prevention is therefore an important public health goal. General practitioners (GPs) play a key role in the management of osteoporosis, both in ensuring timely diagnosis and in providing treatment. Little information is available on standards of care for postmenopausal women with osteoporosis in general practice. Objectives: The primary objective of this study was to describe risk factors and treatment in postmenopausal women with osteoporosis. Secondary objectives were to evaluate treatment compliance and to assess the impact of osteoporosis on quality of life. Methods: This observational, cross-sectional, pharmacoepidemiological study was performed in a primary-care setting in France. A random sample of GPs recruited postmenopausal women with a diagnosis of osteoporosis who had been followed by the investigator for at least 2 years. At inclusion, investigators completed a questionnaire providing information on patient age, osteoporosis duration, risk factors and treatment history. The first three patients recruited by each investigator completed a questionnaire providing information on sociodemographic features, osteoporosis treatments and quality of life. Treatment compliance was quantified using the Test d’Evaluation de l’Observance and quality of life evaluated using the 12-item Short Form Health Survey (SF-12). Results: Overall, 389 physicians included 3097 patients, of whom 1053 completed the patient questionnaire. Risk factors for osteoporotic fracture were identified in 2148 patients (69.4%), most frequently personal or maternal antecedents of osteoporotic fracture and a low body mass index. Of these, 946 (44.0%) presented more than one risk factor. At the time of diagnosis, 629 patients (59.7%) presented
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fractures, which involved the vertebrae in 51.7% of cases, the wrist in 40.5% and the hip in 5.4%. Older patients were more likely to have fractures at the time of diagnosis and to have multiple fractures. After diagnosis, at least one new fracture occurr
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