Prevalence of high fracture risk among Chinese adults in the community: what primary care doctors need to know?

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Abstract Description
Abstract ID :
HAC5611
Submission Type
Authors (including presenting author) :
Dr. YAU KC, Dr. CHIANG LK, Dr. HO KM, Dr. NG Lorna, Dr. CHEN XR Catherine, Dr. LI YC
Affiliation :
Department of Family Medicine and General Outpatient Clinics (GOPCs), Kowloon Central Cluster (KCC), Hospital Authority.
Introduction :
Prevention of osteoporotic fractures is an essential task for primary care doctors. The Fracture Risk Assessment Tool (FRAX®) launched by the University of Sheffield is a useful international web-based tool to predict 10-year probability of major osteoporotic fracture and hip fracture. After detecting patients with high fracture risk (HFR) in daily practice, primary care physicians could arrange further management including diagnosis and anti-osteoporotic treatment accordingly.
Objectives :
1. To evaluate the prevalence of high fracture risk among Chinese adults who attended a public primary care clinic

2. To explore the clinical risk factors associated with high fracture risk.
Methodology :
Design: Cross-sectional survey conducted in a GOPC of KCC

Subjects: Chinese men aged 50 to 90 or postmenopausal women who had attended KWH GOPC clinic from 18/07/2019 to 30/08/2019.

Outcome assessment: Primary outcomes included prevalence of Chinese adults with HFR (defined as 10-year hip fracture probability (HFP) ≥3 % or a 10-year major osteoporosis-related fracture probability (MOFP) ≥20% based on FRAX) and percentage of patients with known osteoporosis and taking anti-osteoporotic treatment. Secondary outcomes included clinic risk factors associated with HFR.
Result & Outcome :
298 patients were recruited during the study period and 203 (68%) were females. The Prevalence of HFR among Chinese adults was 5.7% (n=17) by 10-yr MOFP and 37.2% (n=111) by 10-year HFP. 52 (17.4%) patients were reported to have known osteoporosis and among them, 16 (5.4%) received anti-osteoporotic treatment. The clinical risk factors associated with HFR among Chinese adults included comorbidity with diabetes mellitus (OR 2.11, 95% CI 1.19-3.75), hypertension (OR 1.70, 95% CI 1.05-2.74)), use of walking aids (OR 7.09, 95% CI 2.94-17.10) and being homebound (OR 5.08, 95% CI 1.93-13.41). Family physicians should be well aware of these risk factors and make concerted effort to prevent osteoporosis and its complications in the community.

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