A SURVEY ON TREATMENT REGIMENS USED IN THE COMMUNITY AND A TEACHING HOSPITAL FOR OSTEOPOROSIS- A COMBINED STUDY IN NORTHERN KERALA

Abstract

Kunhi Kannan1, Muhammed Musthaque2

BACKGROUND
Osteoporosis is a common clinical condition with features of low bone mass and microarchitectural collapse of bone tissue with enhanced bone fragility and increased susceptibility to fracture. Nowadays, it is recognised as a major health problem as it leads to an increased risk of developing spontaneous and traumatic fractures. In India, osteoporotic fractures occur more commonly in both sexes and may occur at a younger age than in the western countries. Though exact prevalence of the disease is not available, nearly 36 million Indians maybe suffering from osteoporosis by 2013. At present, most drugs available in the markets decrease bone loss by inhibiting bone resorption, but the upcoming therapies may increase bone mass by directly increasing bone mass as is the case of parathyroid hormone.
The aim of the study is to conduct a clinical survey of treatment regimens used in the community and a tertiary hospital for osteoporosis.
MATERIALS AND METHODS
The clinical and prescription data of 276 patients were analysed in the northern part of Kerala. The diagnostic criteria used for confirmation of osteoporosis, treatment regimens used, their efficacy and side effects were observed and analysed using standard statistical methods. Patients were divided into 2 groups; group A with 116 patients attending the teaching hospital and 160 groups B patients’ information obtained from physicians in the community.
RESULTS
Among 276 patients, 197 were females and 79 were males with a male-to-female ratio of 1:2.49. Group A showed 28.4% in the 66 to 70 years age group; group B showed 28.75% in the 66 to 70 years age group. The baseline lab investigations were normal. The DXA results in both groups showed T score <2.5 and more in 199 patients (72.10%). The overall incidence of osteoporotic fractures was observed in 63 patients (22.82%). The frequently used treatment regimen was vitamin D and calcium.
CONCLUSION
Osteoporosis was noted more commonly in females than in males. The commonest age group affected was 66 to 75 years. Baseline laboratory investigations are found to normal. The most preferred investigation among the physicians was Dual-Energy X-Ray Absorptiometry (DXA). The commonly used regimen was calcium and vitamin D followed by bisphosphonates. The compliance rate of all the regimens was equal. The overall patient compliance for different regimens using Chi-square calculator using (5 x 5) contingency table the Chi-square statistic was 4.3242. The p-value was 0.3639. The result was not significant at p<0.05. Comparing the end results of different regimens of treatment used in Groups A and B using Chi-square calculator using (5 x 5) contingency table the Chi-square statistic was found to be 1.0482. The p-value was 0.902. The result is not significant at p<0.05.
KEYWORDS
Age, Elderly, Osteoporosis, Drugs, Anti-Osteoporotic Drugs, Metabolism and Calcium.

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