Osteoporosis International

, Volume 26, Issue 11, pp 2579–2585 | Cite as

Two-year adherence to treatment and associated factors in a fracture liaison service in Spain

  • A. Naranjo
  • S. Ojeda-Bruno
  • A. Bilbao-Cantarero
  • J. C. Quevedo-Abeledo
  • B. V. Diaz-González
  • C. Rodríguez-Lozano
Original Article



A fracture liaison service in Spain is able to maintain 73 % of the patients on antiresorptive 2 years after the fracture.


The purpose of this study was to evaluate the 2-year effectiveness of a program for the secondary prevention of fractures.


Fragility fractures in patients over 50 attending the emergency room in our centre are captured by the recruitment system of a secondary prevention program. The unit is attended by a nurse, coordinated by two rheumatologists and with the collaboration of primary care consisted of a training program and annual meetings. The outcome of the program was analysed 2 years after implementation, including: (1) percentage of attendees/eligible; (2) percentage of attendees who start treatment with antiresorptive; (3) percentage of patients who retain treatment after 6, 12, 18 and 24 months; and (4) factors associated to adherence.


After 2 years of implementation, the program detected 1674 patients with fracture, of whom 759 finally entered the program (57 % of eligible). After 3 months, 82 % of patients prescribed an antiresorptive started treatment. After a year, 52 % of the patients in the program, 72 % of those of a prescribed treatment, were taking antiresorptives. Adherence at 24 months among those who had prescribed anti-fracture drugs was 73 %. Factors associated with adherence at 12 months were female sex (76 vs 45 %; p = 0.01) and previous treatment with antiresorptive (86 vs 68 %; p = 0.02).


In Spain, a program designed to prevent secondary fragility fractures based on the collaboration between primary care and rheumatology seems effective in terms of recruitment of patients and adherence to treatment in the mid/long-term.


Adherence Bisphosphonates Fracture liaison service Fragility fracture Osteoporosis Secondary prevention Training program 



Authors give thanks to Carmen Alonso, Fabiola Santana, and Ruben Lopez (Rheumatology), Sinforiano Rodriguez (Geriatry), and Manuel de la Torre (Orthopaedics), Hospital Universitario de Gran Canaria Dr. Negrin, for their collaboration and to Loreto Carmona for revising the manuscript.

Conflicts of interest



Proyecto nacional del Ministerio de Ciencia e Innovación. Instituto de Salud Carlos III: PI11/01429


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2015

Authors and Affiliations

  1. 1.Department of Rheumatology, Hospital Universitario de Gran Canaria Dr. NegrínUniversidad de Las Palmas de Gran CanariaLas Palmas de Gran CanariaSpain
  2. 2.Medical and Surgical Sciences DepartmentUniversidad de Las Palmas de Gran CanariaLas Palmas de Gran CanariaSpain
  3. 3.Primary Care Service, Gerencia de Atención Primaria de Gran CanariaLas Palmas de Gran CanariaSpain

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