Optimizing fracture prevention: the fracture liaison service, an observational study
Summary: The response rate to the invitation to the fracture liaison service and reasons for non-response were evaluated in 2,207 fragility fracture patients. Fifty-one percent responded; non-responders were most often not interested (38 %) or were hip fracture patients. After 1 year of treatment, 88 % was still persistent and 2 % had a new fracture. Introduction: To increase the percentage of elderly fracture patients undergoing a dual energy x-ray absorptiometry (DXA) measurement, and to investigate why some patients did not respond to invitation to our fracture liaison service (FLS). Methods: In four Dutch hospitals, fracture patients ≥50 years were invited through a written or personal invitation at the surgical outpatient department, for a DXA measurement and visit to our FLS. Patients who did not respond were contacted by telephone. In patients diagnosed with osteoporosis, treatment was started. Patients were contacted every 3 months during 1 year to assess drug persistence and the occurrence of subsequent fractures. Results: Of the 2,207 patients who were invited, 50.6 % responded. Most frequent reasons for not responding included: not interested (38 %), already screened/under treatment for osteoporosis (15.7 %), physically unable to attend the clinic (11.5 %), and death (5.2 %). Hip fracture patients responded less frequently (29 %) while patients with a wrist (60 %) or ankle fracture (65.2 %) were more likely to visit the clinic. In 337 responding patients, osteoporosis was diagnosed and treatment was initiated. After 12 months of follow-up, 88 % of the patients were still persistent with anti-osteoporosis therapy and only 2 % suffered a subsequent clinical fracture. Conclusion: In elderly fracture patients, the use of a FLS leads to an increased response rate, a high persistence to drug treatment, and a low rate of subsequent clinical fractures. Additional programs for hip fracture patients are required, as these patients have a low response rate.
|Fracture, Fracture liaison service, Osteoporosis, Persistence, Prevention, Response|
|Osteoporosis International: with other metabolic bone diseases|
|Organisation||Department of Surgery|
Eekman, D.A, van Helden, S.H, Huisman, A.M, Verhaar, H.J, Bultink, I.E.M, Geusens, P.P, … Lems, W.F. (2013). Optimizing fracture prevention: the fracture liaison service, an observational study. Osteoporosis International: with other metabolic bone diseases, 1–9. doi:10.1007/s00198-013-2481-8