Optimizing fracture prevention: the fracture liaison service, an observational study
- D. A. EekmanAffiliated withDepartment of Rheumatology, VU University Medical Center Email author
- , S. H. van HeldenAffiliated withDepartment of Trauma Surgery, Isala Clinics
- , A. M. HuismanAffiliated withDepartment of Rheumatology, Sint Franciscus Gasthuis
- , H. J. J. VerhaarAffiliated withDepartment of Geriatric Medicine, University Medical Center Utrecht
- , I. E. M. BultinkAffiliated withDepartment of Rheumatology, VU University Medical Center
- , P. P. GeusensAffiliated withDepartment of Rheumatology, University HospitalBiomedical Research Institute, University Hasselt
- , P. LipsAffiliated withDepartment of Endocrinology, VU University Medical Center
- , W. F. LemsAffiliated withDepartment of Rheumatology, VU University Medical Center
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
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.
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).
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.
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.
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.
KeywordFracture Fracture liaison service Osteoporosis Persistence Prevention Response
- Optimizing fracture prevention: the fracture liaison service, an observational study
Volume 25, Issue 2 , pp 701-709
- Cover Date
- Print ISSN
- Online ISSN
- Springer London
- Additional Links
- Fracture liaison service
- Industry Sectors
- Author Affiliations
- 1. Department of Rheumatology, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
- 2. Department of Trauma Surgery, Isala Clinics, Zwolle, The Netherlands
- 3. Department of Rheumatology, Sint Franciscus Gasthuis, Rotterdam, The Netherlands
- 4. Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- 5. Department of Rheumatology, University Hospital, Maastricht, The Netherlands
- 6. Biomedical Research Institute, University Hasselt, Diepenbeek, Belgium
- 7. Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands