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Healthy Bones Program targeting at-risk individuals increased DEXA rates, decreased hip fracture rates

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Proactive measures reduced hip fracture rates in at-risk individuals, according to the results of a five-year study.

Researchers tracked more than 620,000 men and women in Southern California aged 60 years and older who had specific risk factors for osteoporosis and hip fractures.

Implementation of a number of initiatives within the Healthy Bones Program at 11 Kaiser Permanente Southern California centers reduced hip fracture rates beyond the goal rate of 25%. The Healthy Bones Program is a screening and hip fracture prevention program that includes orthopedic surgeons who are part of a large multidisciplinary team. The program’s specific initiatives include increasing the use of DEXA and osteoporosis medications, using education and health programs and standardizing practice guidelines.

The researchers identified a 247% increase in the annual DEXA scan use rate, from 21,557 per year in 2002 to 74,770 per year in 2006. The annual DEXA scan use rate increased 600% in men, from 1,549 per year in 2002 to 10,841 in 2006, and 220% in women, from 20,008 to 63,929 in the same period.

Use of the Healthy Bones Program also increased the annual number of patients receiving anti-osteoporosis medications by 135% — 33,208 in 2002 to 78,058 in 2006.

Reductions in hip fracture rate were observed at all 11 centers, ranging from 23.1% to 60.7% with an average reduction of 37.2%.

“It’s a misconception that nothing can be done to prevent or treat osteoporosis. It is possible to achieve at least a 25% reduction in the hip fracture rate in the United States if a more active role is taken by all orthopedic surgeons in osteoporosis disease management. Significant improvements in hip fracture rates are achievable wherever orthopedic surgeons and treatment teams are willing to take a more active role,” Richard M. Dell, MD, a study researcher and an orthopedic surgeon at Kaiser Permanente Bellflower Medical Center, said in a press release.

J Bone Joint Surg Am. 2008;90(suppl 4):188-194.