A new study from the Garvan Institute of Medical Research reveals that people at high risk of fractures who also have complex or multiple chronic medical conditions are less likely to have the underlying cause of the fracture investigated compared to those at high risk but who have no additional chronic conditions.
“No matter the fracture site, we believe fracture is under-prioritised in the clinical setting in a complex patient,” says lead author Dr Dana Bliuc, Senior Research Officer in the Clinical Studies and Epidemiology Lab at Garvan.
“People with complex diseases not only fare worse, but they are less likely to receive treatment, which is a double whammy.
“We think this is because fractures are viewed as less serious than other medical conditions present in patients, and thus not the focus of intervention,” says Dr Bliuc.
“But fracture itself will affect the quality of life and contributes to mortality.”
To investigate the outcomes and the kind of medical treatment people with these fractures receive, the researchers studied prescriptions, Medicare claims and hospital admission data from more than 10,500 Australian patients aged over 45, identified as being at high risk for a future fracture.
They found that in patients in the high-risk group, more than 80% of people were not treated for osteoporosis to prevent future fractures when they should have been, and this dipped even lower for patients with complex medical conditions.
“We need to start changing our paradigm of how we think about disease and treatment to be less about a ‘single disease-single treatment one’, to treating the person as a whole,” says Professor Jacqueline Center, Head of the Clinical Studies and Epidemiology Lab at Garvan.
“Our aim is to improve health in older people, so that people are living well, rather than just living.”
The new study is published in the journal PLOS Medicine.