Determinants of imminent fracture risk in postmenopausal women with osteoporosis.

Osteoporotic fractures are associated with direct patient burden in terms of morbidity and mortality and also exert a significant societal economic burden stemming from direct healthcare resource use (hospitalizations, outpatient visits, prescription medication, rehabilitation, and long-term care), direct nonmedical costs (transportation, caregivers), and indirect costs (time and work impact on family caregivers, lost patient productivity, early retirement) [1–6]. Despite the magnitude of these clinical and economic burdens and the availability of effective treatments, osteoporosis is often undertreated. Suboptimal treatment is an issue even among women with a history of osteoporotic fracture, whose risk is particularly elevated for another fracture. As few as one of every four Medicare patients in the USA received treatment after fracture [7, 8].