There is still a care gap in osteoporosis management for patients with rheumatoid arthritis |
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| Institution: | 1. Department of Medicine, Western University, London, ON, Canada;2. Division of Rheumatology, St. Joseph''s Health Care, London, ON, Canada;1. Unit of orofacial pain and temporomandibular dysfunction, University Dental Clinic, Monastir, Tunisia;2. Department of Radiology, University Dental Clinic, Monastir, Tunisia;1. Unité clinique d’immuno-rhumatologie thérapeutique des maladies articulaires et osseuses, CHRU Lapeyronie, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France;2. Laboratoire de génétique des maladies rares et auto-inflammatoires (centre de référence), CHU Montpellier, Montpellier, France;3. CNRS UMR5048, centre de biochimie structurale, faculté de pharmacie, Montpellier, France;4. Département d’ophtalmologie, hôpital Gui-de-Chauliac, Montpellier, France;1. Department of Rheumatology, Roger Salengro Hospital, Lille 2 University, 59037 Lille, France;2. Department of Rheumatology, Saint-Philibert Hospital, Lille Catholic University, 59160 Lomme, France;3. Department of Internal Medicine, Taaone Hospital, Papeete, French Polynesia;1. Laboratory of Biomedical Physics, University of Antwerp, Antwerp, Belgium;2. Department of Otohinolaryngology, Akershus University Hospital and University of Oslo, Oslo, Norway |
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| Abstract: | ObjectivesTo assess compliance rates with the current Canadian osteoporosis guidelines and whether the Fracture Risk Assessment Tool score in patients with rheumatoid arthritis correlated with the likelihood of receiving osteoporosis treatment and having a bone mineral density test.MethodsCharts of serial outpatients with rheumatoid arthritis were reviewed to collect bone mineral density test data and patients’ use of calcium, vitamin D, and osteoporosis treatment. Odds ratios (OR) were calculated to determine if a higher Fracture Risk Assessment Tool score increased the likelihood of osteoporosis treatment or having a bone mineral density test.ResultsUsing the Fracture Risk Assessment Tool, the 10-year risk of major osteoporotic fracture was high in 92 (12.5%), moderate in 216 (29.3%), and low in 429 (58.2%) patients. Compared to those at low risk, patients identified as high risk were more likely to receive osteoporosis treatment (OR 16.31, 95% CI 9.45–28.13, P < 0.001); calcium (OR 3.89, 95% CI 2.43–6.25, P < 0.001); vitamin D (OR 3.46, 95% CI 2.12–5.64, P < 0.001); and to have had a bone mineral density test (OR 10.22, 95% CI 5.50–18.96, P < 0.001). Among 124 patients currently taking prednisone, half (46.8%) were prescribed a bisphosphonate.ConclusionsAlthough compliance with current osteoporosis guidelines remains low among all patients with rheumatoid arthritis, higher risk patients were more likely to have a bone mineral density test and receive treatment for osteoporosis, as indicated by the clear dose response seen along the 10-year fracture risk from low to high-risk groups. |
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| Keywords: | RA Osteoporosis FRAX Treatment guidelines Adherence Chart audit predictors of adherence |
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