EVALUATION OF MANAGEMENT OF PATIENTS WITH OSTEOPOROTIC FRACTURES BY ORTHOPEDIC RESIDENTS: A CROSS-SECTIONAL OBSERVATIONAL STUDY

AVALIAÇÃO DO MANEJO DE PACIENTES COM FRATURAS OSTEOPORÓTICAS POR RESIDENTES DE ORTOPEDIA: UM ESTUDO TRANSVERSAL OBSERVACIONAL

ABSTRACT

Objective:  To assess whether residents (R1, R2, or R3 - according to the year of residency) of a tertiary orthopedic service investigate, treat and/or refer the patient with osteoporotic fracture for osteoporosis (OP) treatment and whether this learning is improved over the years of residency.

Methods:  Residents answered diagnostic and therapeutic questions related to a clinical case of osteoporotic fracture (OF) in 4 settings, which were initial care in the emergency room, at discharge, during outpatient follow-up at 3 and 6 months. Responses were compared between years of residency.

Results:  Twenty R1, 21 R2, and 19 R3 raised the questions. One resident treated osteoporosis in R1, two in R2, and four in R3. Seventy-five percent of R1, 90.5% of R2, and 68% of R3 referred patients for OP treatment. Over the years, there has been improved prescribing lab tests for osteoporosis (p = 0.028), with 52.6% of third-year residents prescribing adequate lab tests. In the same period, 100% of R3 correctly prescribed prophylaxis for deep vein thrombosis (p = 0.001).

Conclusion:  There is learning, but not enough, for secondary prevention of FO. Level of Evidence I; Prospective Comparative Study.

Keywords:
Osteoporotic fracture; Secondary Prevention; Brazil; Orthopedics; Health knowledge; Attitudes and Practice