COMPARATIVE EVALUATION OF THE FREQUENCY OF PRESCRIPTION OF PHARMACOTHERAPY TO PATIENTS WITH OSTEOPOROTIC FRACTURES BASED ON DIFFERENT DIAGNOSTIC CRITERIA
Prescription of antiresorptive pharmacotherapy in order to prevent subsequent osteoporotic fractures should be preceded by an appropriate diagnosis of this pathology. Today there is a need to select an accessible and sufficiently accurate criterion for the prescription of antiresorptive pharmacotherapy for subsequent osteoporotic fractures prevention. The aim of the study was to compare the frequency of prescriptions based on different diagnostic criteria and the effectiveness of specific antiosteoporotic pharmacotherapy in patients with extravertebral osteoporotic fractures of typical localizations. The study included 1656 females (71%) and 676 males (29%) with osteoporotic extravertebral bone fractures of the three most typical localizations: in the proximal femur (1214 - 52%), in the distal radius (690 - 29.6%) and in the proximal shoulder (428 - 18.4%). The first group of 765 patients were treated in 2011 - 2013 years, the second - 1160 patients who were treated in 1014 - 2016. The third group treated in 2017 consisted of 407 patients. In the first group, indications for therapy were determined on the basis of radiological investigation, in the second and third - on the basis of the results of the FRAX scale. The percentage of patients who were prescribed or not prescribed antiresorptive pharmacotherapy were determined and compared in all three clinical groups as a whole, as well as in three subgroups based on the location of osteoporotic fractures. It was found that the frequency of antiresorptive pharmacotherapy prescription in 2011 - 2013 was 57.1% among patients of the first clinical group. In the period from 2014 to 2016, this indicator significantly increased to 73.3% and was significantly higher (p <0.05) in the second clinical group compared to the first group. In the third group, observed in 2017, the noted trend continued, and the proportion of patients with prescribed antiresorptive pharmacotherapy increased to 75%. It also turned out to be significantly higher (p <0.05) compared to the corresponding indicator in the first clinical group (57.1%), and there were no statistically significant differences with the second group (p> 0.05).The same result was recorded when comparing all three subgroups of patients: with fractures of the proximal humerus, distal forearm and proximal femur. The proportion of patients with subsequent osteoporotic fractures, on the contrary, progressively decreased from the first group to the third clinical group.