Skip to main content

Advertisement

Log in

Secondary prevention of osteoporotic fractures: evaluation of the Amiens University Hospital’s fracture liaison service between January 2010 and December 2011

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

The main goal was to assess the performance of the fracture liaison service (FLS) at Amiens University Hospital for 2 years. Osteoporosis medication was prescribed in 182 patients and 67.4 % were still taking treatment 18 months later. Secondary prevention of osteoporotic fractures has improved since the creation of the FLS.

Introduction

The main goal of the present study was to assess the performance and results of the FLS at Amiens University Hospital, France.

Methods

This was an observational, single-center, ambispective study. All patients admitted to Amiens University Hospital between January 2010 and December 2011 for a low-trauma fracture (vertebral and non-vertebral fractures) were identified by a FLS nurse. Patients willing to enter the study were assessed for their osteoporosis risk factors, daily calcium intake, bone mineral density (BMD) by DXA, and clinical chemistry parameters. When indicated, the patients received a prescription for osteoporosis medication. The participation rate, type of osteoporosis medications, initiation rate, and osteoporosis treatment persistence 12 and 18 months later were assessed.

Results

Of the 1,439 patients contacted, 872 were eligible for inclusion. A total of 335 patients (participation rate 38.4 %) were included in the study (mean age 63.3 years; 71.9 % female). All patients underwent BMD measurement, and more than 90 % of them were assessed for osteoporosis risk factors and daily calcium intake. Osteoporosis medication was prescribed in 182 (75.5 %) of the patients in whom it was indicated (n = 241). The main class of osteoporosis medications prescribed was bisphosphonates (83.5 %), and 74.1 and 67.4 % of treated patients were still taking treatment 12 and 18 months later, respectively. The main cause of treatment discontinuation was non-renewal of the prescription by the patient’s general practitioner.

Conclusion

Secondary prevention of osteoporotic fractures in Amiens University Hospital has improved since the creation of the FLS, with encouragingly high treatment initiation and persistence rates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Maravic M, Taupin P, Landais P, Roux C (2011) Change in hip fracture incidence over the last 6 years in France. Osteoporos Int 22:791–801

    Article  Google Scholar 

  2. Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301:513–521

    Article  Google Scholar 

  3. Leboime A, Confavreux CB, Mehsen N, Paccou J, David C, Roux C (2010) Osteoporosis and mortality. Joint Bone Spine 77(2):S107–S112

    Article  PubMed  Google Scholar 

  4. Bliuc D, Nguyen ND, Nguyen TV, Eisman JA, Center JR (2013) Compound risk of high mortality following osteoporotic fracture and refracture in elderly women and men. J Bone Miner Res 28:2317–2324

    Article  Google Scholar 

  5. Body JJ, Bergmann P, Boonen S, Boutsen Y, Devogelaer JP, Goemaere S et al (2010) Evidence-based guidelines for the pharmacological treatment of postmenopausal osteoporosis: a consensus document by the Belgian Bone Club. Osteoporos Int 21:1657–1680

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bolland MJ, Grey AB, Gamble GD, Reid IR (2010) Effect of osteoporosis treatment on mortality: a meta-analysis. J Clinic Endocrinol Metab 95:1174–1181

    Article  CAS  Google Scholar 

  7. Cranney A, Guyatt G, Griffith L, Wells G, Tugwell P, Rosen C et al (2002) Meta-analyses of therapies for postmenopausal osteoporosis. IX: summary of meta-analyses of therapies for postmenopausal osteoporosis. Endocr Rev 23:570–578

    Article  PubMed  CAS  Google Scholar 

  8. Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR et al (2009) Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Eng J Med 361:756–765

    Article  CAS  Google Scholar 

  9. Lyles KW, Colon-Emeric CS, Magaziner JS (2007) HORIZON Recurrent Fracture Trial. Zoledronic acid and clinical fractures and mortality after hip fracture. N Eng J Med 357:1799–1809

    Article  CAS  Google Scholar 

  10. Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E (2008) FRAX® and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Briot K, Cortet B, Thomas T, Audran M, Blain H, Breuil V et al (2012) 2012 update of French guidelines for the pharmacological treatment of postmenopausal osteoporosis. Joint Bone Spine 79:304–313

    Article  PubMed  Google Scholar 

  12. Eisman JA, Bogoch ER, Dell R, Harrington JT, McKinney RE Jr, McLellan A 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

    Article  PubMed  Google Scholar 

  13. Boudou L, Gerbay B, Chopin F, Ollagnier E, Collet P, Thomas T (2011) Management of osteoporosis in fracture liaison service associated with long-term adherence to treatment. Osteoporos Int 22:2099–2106

    Article  PubMed  CAS  Google Scholar 

  14. Ganda K, Puech M, Chen JS, Speerin R, Bleasel J, Center JR et al (2013) Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int 24:393–406

    Google Scholar 

  15. Eekman DA, van Helden SH, Huisman AM, Verhaar HJJ, Bultink IEM, Geusens PP et al (2014) Optimizing fracture prevention: the fracture liaison service, an observational study. Osteoporos Int 25:701–709

    Article  PubMed  CAS  Google Scholar 

  16. Vaile JH, Sullivan L, Connor D, Bleasel JF (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

    Article  PubMed  CAS  Google Scholar 

  17. Akesson K, Marsh D, Mitchell PJ, McLellan AR, Stenmark J, Pierroz DD et al (2013) Capture the fracture: a best practice framework and global campaign to break the fragility fracture cycle. Osteoporos Int 24:2135–2152

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  18. Cooper C, Mitchell P, Kanis JA (2011) Breaking the fragility fracture cycle. Osteoporos Int 22:2049–2050

    Article  PubMed  CAS  Google Scholar 

  19. Huntjens KM, van Geel TC, Geusens PP, Winkens B, van den Bergh J, Brink PR et al (2011) Impact of guideline implementation by a fracture nurse on subsequent fractures and mortality in patients presenting with non-vertebral fractures. Injury 42(4):39–43

    Article  Google Scholar 

  20. McLellan AR, Gallacher SJ, Fraser M, McQuillian C (2003) The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 14:1028–1034

    Article  PubMed  Google Scholar 

  21. Gallacher SJ (2005) Setting up an osteoporosis fracture liaison service: background and potential outcomes. Best Pract Res Clin Rheumatol 19:1081–1094

    Article  PubMed  Google Scholar 

  22. Huntjens KM, van Geel TA, Blonk MC, Hegeman JH, van der Elst M, Willems P (2011) Implementation of osteoporosis guidelines: a survey of five large fracture liaison services in the Netherlands. Osteoporos Int 22:2129–2135

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  23. Ojeda-Bruno S, Naranjo A, Erausquin C, Francisco-Hernandez F, Rua-Figueroa I, Quevedo JC et al (2011) Secondary prevention program for osteoporotic fractures and long-term adherence to bisphosphonates. Osteoporos Int 22:1821–1828

    Article  PubMed  CAS  Google Scholar 

  24. Chandran M, Tan MZ, Cheen M, Tan SB, Leong M, Lau TC (2013) Secondary prevention of osteoporotic fractures—an “OPTIMAL” model of care from Singapore. Osteoporos Int 24:2809–2817

    Article  PubMed  CAS  Google Scholar 

  25. Premaor MO, Pilbrow L, Tonkin C, Adams M, Parker RA, Compston J (2010) Low rates of treatment in postmenopausal women with a history of low trauma fractures: results of audit in a fracture liaison service. Q J Med 103:33–40

    Article  CAS  Google Scholar 

  26. Prieti-Alhambra D, Judge A, Adren NK, Cooper C, Lyles KW, Javaid MK (2014) Fracture prevention in patients with cognitive impairment presenting with a hip fracture: secondary analysis of data from the HORIZON Recurrent Fracture Trial. Osteoporos Int 25:77–83

    Article  Google Scholar 

  27. Diab DL, Watts NB (2014) Denosumab in osteoporosis. Expert Opin Drug Saf 13:247–253

    Article  PubMed  CAS  Google Scholar 

  28. Howat I, Carty D, Harrison J, Fraser M, McLellan AR (2007) Vertebral fracture assessment in patients presenting with incident nonvertebral fractures. Clin Endocrinol 67:923–930

    Article  Google Scholar 

  29. Gallacher SJ, Gallagher AP, McQuillian C, Mitchell PJ, Dixon T (2007) The prevalence of vertebral fracture amongst patients presenting with non-vertebral fractures. Osteoporos Int 18:185–192

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  30. Paccou J, Confavreux CB, David C, Leboime A, Mehsen N, Cortet B (2010) Stabilized severe osteoporosis: should the treatment be stopped? Joint Bone Spine 77:120–127

    Article  Google Scholar 

  31. Streeten EA, Mohamed A, Gandhi A, Orwig D, Sack P, Sterling R et al (2006) The inpatient consultation approach to osteoporosis treatment in patients with a fracture. Is automatic approach to osteoporosis needed? J Bone Joint Surg Am 88:1968–1974

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Corinne Fauvet and Alain Henocq for their technical assistance.

Conflicts of interest

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Paccou.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dehamchia-Rehailia, N., Ursu, D., Henry-Desailly, I. et al. Secondary prevention of osteoporotic fractures: evaluation of the Amiens University Hospital’s fracture liaison service between January 2010 and December 2011. Osteoporos Int 25, 2409–2416 (2014). https://doi.org/10.1007/s00198-014-2774-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-014-2774-6

Keywords

Navigation