Aging Clinical and Experimental Research

, Volume 29, Issue 2, pp 331–334 | Cite as

Results of a fracture liaison service on hip fracture patients in an open healthcare system

  • Felicia CosmanEmail author
  • Kathleen Nicpon
  • Jeri W. Nieves
Short Communication


We assessed osteoporosis management in patients admitted for rehabilitation of acute hip fracture to an open system community hospital before and after institution of a fracture liaison service (FLS). Pre-FLS, we surveyed 60 patients 4–6 months after hip fracture. Subsequently, the FLS program performed routine consultations, and recommended lab, bone density testing (BMD) and osteoporosis medication. FLS program outcomes were assessed by survey in 75 patients after hip fracture. In the pre-FLS population, after hip fracture, 55 % changed calcium intake, 48 % changed vitamin D intake, and 35 % obtained a BMD. Osteoporosis medication was taken by 38 % before and 33 % after hip fracture. Post-FLS, 56 % changed calcium intake, 68 % changed vitamin D intake and 65 % obtained a BMD. Post-FLS, osteoporosis medication was taken by 21 % of patients before and 19 % after hip fracture. Our FLS program in hip fracture patients improved non-pharmacologic measures, but not the use of osteoporosis medication.


Hip fracture Osteoporosis treatment FLS 



Funding for this Investigator Initiated project was provided by Novartis Corp (East Hanover, NJ).

Compliance with ethical standards

Conflict of interest

Dr Cosman received consulting, advisory and speaking fees from Novartis. Dr Nieves and Ms. Nicpon have nothing to disclose.


  1. 1.
    Eisman JA, Bogoch ER, Dell R et al (2012) Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res 27:2039–2046. doi: 10.1002/jbmr.1698 CrossRefPubMedGoogle Scholar
  2. 2.
    Solomon DH, Patrick AR, Schousboe J et al (2014) The potential economic benefits of improved postfracture care: a cost-effectiveness analysis of a fracture liaison service in the US health-care system. J Bone Miner Res 29:1667–1674. doi: 10.1002/jbmr.2180 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    McLellan AR, Wolowacz SE, Zimovetz EA et al (2011) Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. Osteoporos Int 22:2083–2098. doi: 10.1007/s00198-011-1534-0 CrossRefPubMedGoogle Scholar
  4. 4.
    Olenginski TP, Maloney-Saxon G, Matzko CK et al (2015) High-risk osteoporosis clinic (HiROC): improving osteoporosis and postfracture care with an organized, programmatic approach. Osteoporos Int 26:801–810. doi: 10.1007/s00198-014-2967-z CrossRefPubMedGoogle Scholar
  5. 5.
    Van der Kallen J, Giles M, Cooper K et al (2014) A fracture prevention service reduces further fractures two years after incident minimal trauma fracture. Int J Rheum Dis 17:195–203. doi: 10.1111/1756-185x.12101 CrossRefPubMedGoogle Scholar
  6. 6.
    Huntjens KM, van Geel TA, van den Bergh JP et al (2014) Fracture liaison service: impact on subsequent nonvertebral fracture incidence and mortality. J Bone Joint Surg Am 96:e29. doi: 10.2106/JBJS.L.00223 CrossRefPubMedGoogle Scholar
  7. 7.
    Mitchell PJ (2013) Best practices in secondary fracture prevention: fracture liaison services. Curr Osteoporos Rep 11:52–60. doi: 10.1007/s11914-012-0130-3 CrossRefPubMedGoogle Scholar
  8. 8.
    Dell R (2011) Fracture prevention in Kaiser Permanente Southern California. Osteoporos Int 22:457–460. doi: 10.1007/s00198-011-1712-0 CrossRefPubMedGoogle Scholar
  9. 9.
    Solomon DH, Johnston SS, Boytsov NN et al (2014) Osteoporosis medication use after hip fracture in U.S. patients between 2002 and 2011. J Bone Miner Res 29:1929–1937. doi: 10.1002/jbmr.2202 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Vaile JH, Sullivan L, Connor D et al (2013) A year of fractures: a snapshot analysis of the logistics, problems and outcomes of a hospital-based fracture liaison service. Osteoporos Int 24:2619–2625. doi: 10.1007/s00198-013-2357-y CrossRefPubMedGoogle Scholar
  11. 11.
    Eekman DA, van Helden SH, Huisman AM et al (2014) Optimizing fracture prevention: the fracture liaison service, an observational study. Osteoporos Int 25:701–709. doi: 10.1007/s00198-013-2481-8 CrossRefPubMedGoogle Scholar
  12. 12.
    Lyles KW, Colon-Emeric CS, Magaziner JS et al (2007) Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med 357:1799–1809. doi: 10.1056/NEJMoa074941 CrossRefPubMedGoogle Scholar
  13. 13.
    Siris ES, Adler R, Bilezikian J et al (2014) The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporos Int 25:1439–1443. doi: 10.1007/s00198-014-2655-z CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Gallacher SJ, Gallagher AP, McQuillian C et al (2007) The prevalence of vertebral fracture amongst patients presenting with non-vertebral fractures. Osteoporos Int 18:185–192. doi: 10.1007/s00198-006-0211-1 CrossRefPubMedGoogle Scholar
  15. 15.
    Cosman F, de Beur SJ, LeBoff MS et al (2014) Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int 25:2359–2381. doi: 10.1007/s00198-014-2794-2 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Felicia Cosman
    • 1
    • 2
    Email author
  • Kathleen Nicpon
    • 1
  • Jeri W. Nieves
    • 1
    • 3
  1. 1.Helen Hayes HospitalWest HaverstrawUSA
  2. 2.Department of MedicineColumbia UniversityNYUSA
  3. 3.Department of EpidemiologyColumbia UniversityNYUSA

Personalised recommendations