Osteoporosis "case managers" seen helpful

NEW YORK (Reuters Health) - The use of a case manager can significantly boost treatment rates among elderly people with the bone-thinning disease osteoporosis who have suffered a hip fracture and are at high risk of future fractures, research suggests.

Undertreatment of osteoporosis in people with hip fracture is a problem, the researchers explain, and few intervention studies have demonstrated meaningful improvements in the quality of osteoporosis care in such patients.

Dr. Donald W. Morrish from University of Alberta, Edmonton, Canada and colleagues designed an osteoporosis case manager intervention and compared it with usual care in 220 older adults with a history of hip fracture.

The case manager counseled patients about the importance of bone mineral density (BMD) testing and the availability of drug therapy and other treatments to reduce the risk of future fractures. Case managers also scheduled BMD testing.

Morrish and colleagues found that people assigned a case manager were 4.7 times more likely than those receiving usual care to be treated for osteoporosis with appropriate drug therapy 6 months after fracturing their hip.

In addition, far more patients in the case manager group (80 percent) than in the control group (29 percent) underwent BMD testing within 6 months of hip fracture.

The researchers conclude that a case manager intervention that is practical and inexpensive ($50.00 per patient) can improve the quality of osteoporosis care for community-dwelling elderly patients at high risk of fracture.

SOURCE: Archives of Internal Medicine, October 22, 2007.