Management of vertebral compression fracture in general practice: BEACH program.
The pain associated with vertebral compression fractures can cause significant loss of function and quality of life for older adults. Despite this, there is little consensus on how best to manage this condition.To describe usual care provided by general practitioners (GPs) in Australia for the manag...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2017-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC5417429?pdf=render |
id |
doaj-a153beb6d4fd4ef2acd387d0b097f99c |
---|---|
record_format |
Article |
spelling |
doaj-a153beb6d4fd4ef2acd387d0b097f99c2020-11-24T21:30:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01125e017635110.1371/journal.pone.0176351Management of vertebral compression fracture in general practice: BEACH program.Rodrigo Z MegaleAllan PollackHelena BrittJane LatimerVasi NaganathanAndrew J McLachlanManuela L FerreiraThe pain associated with vertebral compression fractures can cause significant loss of function and quality of life for older adults. Despite this, there is little consensus on how best to manage this condition.To describe usual care provided by general practitioners (GPs) in Australia for the management of vertebral compression fractures.Data from the Bettering the Evaluation And Care of Health (BEACH) program collected between April 2005 and March 2015 was used for this study. Each year, a random sample of approximately 1,000 GPs each recorded information on 100 consecutive encounters. We selected those encounters at which vertebral compression fracture was managed. Analyses of management options were limited to encounters with patients aged 50 years or over.i) patient demographics; ii) diagnoses/problems managed; iii) the management provided for vertebral compression fracture during the encounter. Robust 95% confidence intervals, adjusted for the cluster survey design, were used to assess significant differences between group means.Vertebral compression fractures were managed in 211 (0.022%; 95% CI: 0.018-0.025) of the 977,300 BEACH encounters recorded April 2005- March 2015. That provides a national annual estimate of 26,000 (95% CI: 22,000-29,000) encounters at which vertebral fractures were managed. At encounters with patients aged 50 years or over (those at higher risk of primary osteoporosis), prescription of analgesics was the most common management action, particularly opioids analgesics (47.1 per 100 vertebral fractures; 95% CI: 38.4-55.7). Prescriptions of paracetamol (8.2; 95% CI: 4-12.4) or non-steroidal anti-inflammatory drugs (4.1; 95% CI: 1.1-7.1) were less frequent. Non-pharmacological treatment was provided at a rate of 22.4 per 100 vertebral fractures (95% CI: 14.6-30.1). At least one referral (to hospital, specialist, allied health care or other) was given for 12.3 per 100 vertebral fractures (95% CI: 7.8-16.8).The prescription of oral opioid analgesics remains the common general practice approach for vertebral compression fractures management, despite the lack of evidence to support this. Clinical trials addressing management of these fractures are urgently needed to improve the quality of care patients receive.http://europepmc.org/articles/PMC5417429?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Rodrigo Z Megale Allan Pollack Helena Britt Jane Latimer Vasi Naganathan Andrew J McLachlan Manuela L Ferreira |
spellingShingle |
Rodrigo Z Megale Allan Pollack Helena Britt Jane Latimer Vasi Naganathan Andrew J McLachlan Manuela L Ferreira Management of vertebral compression fracture in general practice: BEACH program. PLoS ONE |
author_facet |
Rodrigo Z Megale Allan Pollack Helena Britt Jane Latimer Vasi Naganathan Andrew J McLachlan Manuela L Ferreira |
author_sort |
Rodrigo Z Megale |
title |
Management of vertebral compression fracture in general practice: BEACH program. |
title_short |
Management of vertebral compression fracture in general practice: BEACH program. |
title_full |
Management of vertebral compression fracture in general practice: BEACH program. |
title_fullStr |
Management of vertebral compression fracture in general practice: BEACH program. |
title_full_unstemmed |
Management of vertebral compression fracture in general practice: BEACH program. |
title_sort |
management of vertebral compression fracture in general practice: beach program. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2017-01-01 |
description |
The pain associated with vertebral compression fractures can cause significant loss of function and quality of life for older adults. Despite this, there is little consensus on how best to manage this condition.To describe usual care provided by general practitioners (GPs) in Australia for the management of vertebral compression fractures.Data from the Bettering the Evaluation And Care of Health (BEACH) program collected between April 2005 and March 2015 was used for this study. Each year, a random sample of approximately 1,000 GPs each recorded information on 100 consecutive encounters. We selected those encounters at which vertebral compression fracture was managed. Analyses of management options were limited to encounters with patients aged 50 years or over.i) patient demographics; ii) diagnoses/problems managed; iii) the management provided for vertebral compression fracture during the encounter. Robust 95% confidence intervals, adjusted for the cluster survey design, were used to assess significant differences between group means.Vertebral compression fractures were managed in 211 (0.022%; 95% CI: 0.018-0.025) of the 977,300 BEACH encounters recorded April 2005- March 2015. That provides a national annual estimate of 26,000 (95% CI: 22,000-29,000) encounters at which vertebral fractures were managed. At encounters with patients aged 50 years or over (those at higher risk of primary osteoporosis), prescription of analgesics was the most common management action, particularly opioids analgesics (47.1 per 100 vertebral fractures; 95% CI: 38.4-55.7). Prescriptions of paracetamol (8.2; 95% CI: 4-12.4) or non-steroidal anti-inflammatory drugs (4.1; 95% CI: 1.1-7.1) were less frequent. Non-pharmacological treatment was provided at a rate of 22.4 per 100 vertebral fractures (95% CI: 14.6-30.1). At least one referral (to hospital, specialist, allied health care or other) was given for 12.3 per 100 vertebral fractures (95% CI: 7.8-16.8).The prescription of oral opioid analgesics remains the common general practice approach for vertebral compression fractures management, despite the lack of evidence to support this. Clinical trials addressing management of these fractures are urgently needed to improve the quality of care patients receive. |
url |
http://europepmc.org/articles/PMC5417429?pdf=render |
work_keys_str_mv |
AT rodrigozmegale managementofvertebralcompressionfractureingeneralpracticebeachprogram AT allanpollack managementofvertebralcompressionfractureingeneralpracticebeachprogram AT helenabritt managementofvertebralcompressionfractureingeneralpracticebeachprogram AT janelatimer managementofvertebralcompressionfractureingeneralpracticebeachprogram AT vasinaganathan managementofvertebralcompressionfractureingeneralpracticebeachprogram AT andrewjmclachlan managementofvertebralcompressionfractureingeneralpracticebeachprogram AT manuelalferreira managementofvertebralcompressionfractureingeneralpracticebeachprogram |
_version_ |
1725963372746244096 |