| |
| |
![]() |
| |
|
| |
|
| |
|
SINGAPORE: Imagine bones so fragile that a slight fall can cause them to crack or shatter. For sufferers of the brittle bone disease osteoporosis, the result can be painful, and for the elderly who make up a large proportion of those afflicted, life-threatening.
According to Dr Lau Tang Ching, a consultant rheumatologist at Tan Tock Seng Hospital (TTSH), studies show a quarter of the elderly with an osteoporosis hip fracture die within a year of the injury from complications like pneumonia and bed sores. Among the survivors, about one in 10 are bed-ridden, and another quarter wheelchair-bound, he added.
The incidence of osteoporosis fractures here, also called fragility fractures, is going up in tandem with the greying population. Currently, one in 12 Singaporeans is aged 65 and over, but this will rise to one in five by 2030.
Hip fractures have risen four-fold since 1960 and affect about one in every 250 persons aged over 50 now, while an estimated 20,000 female Singaporeans aged 50 to 80 have the condition.
This adds urgency for better osteoporosis management here, especially among those who have already had one fall, as they were more likely to suffer a subsequent, and more fatal, injury, said Dr Lau.
A recently-concluded Osteoporosis Disease Management Programme by the National Healthcare Group (NHG) ran from 2003 to last year and included some 1,000 patients from TTSH, the National University Hospital and Alexandra Hospital. The findings of the programme may shed some light on improving patient outcomes.
Prior to the programme, only about 16 per cent of patients with fragility hip fractures were on osteoporosis treatment post-injury, and this proportion dropped to 3.8 per cent after two years.
But, through counselling by specially-trained case managers, the take-up rate of osteoporosis treatment climbed to 44 per cent, while the adherence rate after two years was 71.2 per cent.
Ms Fadzleen Johari, an osteoporosis case manager at TTSH, counsels six to 10 patients a day, and has seen a marked difference in patients. The rapport she builds with these patients through face-to-face sessions and call reminders has made them more aware and empowered, she said.
More significantly, the rate of overall fractures has dropped by 42 per cent. This means significant savings as the average hospitalisation bill for a fragility fracture is about S$12,000, and subsequent cost of care in the first year can be double that.
Dr Lau, who presented the findings of the study at Thursday's NHG Disease Management Conference, said that the scheme would be fine-tuned and expanded. - TODAY/fa
|
