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Review Question - QID 3145

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QID 3145 (Type "3145" in App Search)
An 80 year-old female undergoes ORIF of her hip fracture without any complications. A hospitalist consult was obtained for medical clearance pre-operatively, and she was diagnosed with osteoporosis. Which of the following treatment scenarios will lead to the best management of the patient's osteoporosis?

Schedule a follow-up appointment with the patients primary care physician to initiate therapy

4%

90/2300

Order a physical therapy consult and initiate an exercise plan

1%

29/2300

Have the patient meet with a nutritionist to increase her calcium and vitamin D intake

2%

41/2300

Start bisphosphonates, and have the patient follow-up with her primary care physician

11%

252/2300

Perform a metabolic work-up as an inpatient, and set-up an appointment in an osteoporosis clinic

82%

1879/2300

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The initiation of appropriate osteoporosis treatment following hip fractures occurs at a surprisingly low rate. Physical therapy and dietary changes are not appropriate initial treatments for osteoporosis, and bisphosphonate therapy should be prescribed by the physician who will be following and managing the patient's osteoporosis.

Miki et al performed a prospective randomized trial where they compared the rates of osteoporosis treatment initiation. The percentage of patients who were on pharmacologic treatment at 6 months post-injury was 58% in the group whose treatment was directed by the orthopedic surgeon and osteoporosis clinic, and 29% when managed by the primary care physician alone.

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