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Characterization of fracture liaison service non-responders after invitation by home visits and questionnaires

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Abstract

Summary

This study aimed to gain insight in specific characteristics and beliefs of FLS non-responders.

Introduction

The proportion of non-responding fracture liaison service (FLS) invitees is high but characteristics of FLS non-responders are unknown.

Methods

We contacted FLS non-responders by telephone to consent with home visit (HV) and to fill in a questionnaire or, if HV was refused, to receive a questionnaire by post (Q), to gain insight in beliefs on fracture cause and subsequent fracture risk.

Results

Out of 716 FLS invitees, 510 attended, nine declined, and 197 did not respond. Of these non-responders, 181 patients were consecutively traced and phoned until 50 consented with HV. Forty-two declined HV but consented with Q. Excluded were eight Q-consenters in whom no choice was offered (either HV or Q) and 81 patients who declined any proposition (non-HV|Q). 62% HV and Q could recall the FLS invitation letter. The fracture cause was differently believed between HV and Q; the fall (96% versus 79%, p = .02), bad physical condition (36% versus 2%, p = .0001), dizziness or imbalance (24% versus Q 7%, p = .03), osteoporosis (16% versus 2%, p = .02), and increased fracture risk (26% versus 17%, NS). Age ≥ 70, woman, and major fracture were significantly associated with HV consent compared to Q (OR 2.7, 2.5, and 2.4, respectively) and HV compared to non-HV|Q (OR 16.8, 5.3, and 6.1).

Conclusion

FLS non-responders consider fracture risk as low. Note, 50 patients (about 25%) consented with a home visit after one telephone call, mainly older women with a major fracture. This non-responder subgroup with high subsequent fracture risk is therefore approachable for secondary fracture prevention.

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Acknowledgments

We are grateful to Mrs. Sabine ’t Hart, Mrs. Wil Aarssen, and Mrs. Maria van Woerden for their excellent secretarial services.

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Authors and Affiliations

  1. Department of Orthopedics and Trauma surgery, Fracture Liaison Service, Reinier de Graaf Hospital, Delft, The Netherlands

    P. van den Berg

  2. Department of Medical Laboratories, Association of Clinical Chemistry, Reinier the Graaf Hospital, Delft, The Netherlands

    P.M.M. van Haard

  3. Department of Internal Medicine, Subdivision Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands

    P.P. Geusens & J.P. van den Bergh

  4. Hasselt University, Hasselt, Belgium

    P.P. Geusens & J.P. van den Bergh

  5. Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands

    J.P. van den Bergh

  6. Department of Internal Medicine and Endocrinology, Reinier the Graaf Hospital, Delft, The Netherlands

    D.H. Schweitzer

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  1. P. van den Berg
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  2. P.M.M. van Haard
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  3. P.P. Geusens
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Correspondence to P. van den Berg.

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van den Berg, P., van Haard, P., Geusens, P. et al. Characterization of fracture liaison service non-responders after invitation by home visits and questionnaires. Osteoporos Int 31, 2007–2015 (2020). https://doi.org/10.1007/s00198-020-05442-9

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