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1.
Osteoporos Int ; 30(9): 1899, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31286148

RESUMEN

The original version of this article, published on 5 June 2019, an author's name was misspelled.

2.
Osteoporos Int ; 30(9): 1779-1788, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31190123

RESUMEN

The purpose of this study was to assess the performance of our Fracture Liaison Service (FLS) over a period of 2 years. Osteoporosis medication was prescribed for 243 patients, and zoledronic acid was the main drug prescribed (60.2%). INTRODUCTION: A Fracture Liaison Service (FLS) was implemented at Lille University Hospital in 2016. The main purpose of this study was to assess the performance of the FLS using criteria proposed by the International Osteoporosis Foundation (IOF). METHODS: The criteria used were patient identification, patient evaluation, post-fracture assessment timing, vertebral-fracture identification, blood and bone mineral density (BMD) testing, falls prevention, multifaceted health and lifestyle risk-factor assessment, and medication initiation and review. RESULTS: Between January 2016 and January 2018, 736 patients (≥ 50 years old) with a recent history of fragility fracture (≤ 12 months) were identified. The identification rate for hip fractures was 74.2%. However, patient evaluation for all type of fractures was quite low (30.3%) since many patients failed to attend the FLS unit. The reasons for non-attendance were refusal, agreed but subsequently failed to attend, and still waiting to be seen. In all, 256 patients (76.6% female, mean (SD) age 74.3 (11.0) years) were seen at the FLS. Mean (SD) post-fracture assessment timing was 13.3 (9.3) weeks. Of the 139 patients seen for a non-vertebral fracture, 103 were assessed for vertebral fractures, and at least one new vertebral fracture was found in 45 of them (43.7%). Osteoporosis medication was prescribed for 243 (94.9%) patients. The main osteoporosis drug prescribed was zoledronic acid (60.2%). CONCLUSIONS: Secondary prevention of osteoporotic fractures has improved since the implementation of the FLS. However, patient identification, patient evaluation, and post-fracture assessment timing still need to be improved.


Asunto(s)
Fracturas Osteoporóticas/prevención & control , Prevención Secundaria/métodos , Accidentes por Caídas/prevención & control , Anciano , Anciano de 80 o más Años , Conservadores de la Densidad Ósea/uso terapéutico , Comunicación , Vías Clínicas/organización & administración , Prestación Integrada de Atención de Salud/organización & administración , Prestación Integrada de Atención de Salud/normas , Femenino , Francia/epidemiología , Investigación sobre Servicios de Salud/métodos , Hospitales Universitarios/organización & administración , Hospitales Universitarios/normas , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Pacientes no Presentados/estadística & datos numéricos , Osteoporosis/tratamiento farmacológico , Osteoporosis/epidemiología , Fracturas Osteoporóticas/epidemiología , Indicadores de Calidad de la Atención de Salud , Estudios Retrospectivos , Medición de Riesgo/métodos , Prevención Secundaria/organización & administración , Prevención Secundaria/normas
4.
Ann Phys Rehabil Med ; 54(4): 248-58, 2011 Jun.
Artículo en Inglés, Francés | MEDLINE | ID: mdl-21612997

RESUMEN

UNLABELLED: Fear of falling may be as debilitating as the fall itself, leading to a restriction in activities and even a loss of autonomy. OBJECTIVES: The main objective was to evaluate the prevalence of the fear of falling among elderly fallers. The secondary objectives were to determine the factors associated with the fear of falling and evaluate the impact of this fear on the activity "getting out of the house". PATIENTS AND METHOD: Prospective study conducted between 1995 and 2006 in which fallers and patients at high risk for falling were seen at baseline by the multidisciplinary falls consultation team (including a geriatrician, a neurologist and a physical medicine and rehabilitation physician) and then, again 6 month later, by the same geriatrician. The fear of falling was evaluated with a yes/no question: "are you afraid of falling?". RESULTS: Out of 635 patients with a mean age of 80.6 years, 502 patients (78%) expressed a fear of falling. Patients with fear of falling were not older than those who did not report this fear, but the former were mostly women (P<0,001), who experienced more falls in the 6 months preceding the consultation (P=0.01), reported more frequently a long period of time spent on the floor after a fall (P<0.001), had more balance disorders (P=0.002) and finally, were using more frequently a walking technical aid (P=0.02). Patients with fear of falling were not going out alone as much as the fearless group (31% vs 53%, P<0.0001). Eighty-two percent of patients in the fearful group admitted to avoiding going out because they were afraid of falling. CONCLUSION: The strong prevalence of the fear of falling observed in this population and its consequences in terms of restricted activities justifies systematically screening for it in fallers or patients at risk for falling.


Asunto(s)
Accidentes por Caídas , Miedo/psicología , Anciano , Anciano de 80 o más Años , Femenino , Geriatría , Personas Imposibilitadas/psicología , Humanos , Comunicación Interdisciplinaria , Masculino , Neurología , Medicina Física y Rehabilitación , Equilibrio Postural , Estudios Prospectivos , Riesgo , Trastornos de la Sensación/complicaciones , Poblaciones Vulnerables
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