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One-year outcomes of an osteoporosis liaison services program initiated within a healthcare system

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Abstract

Summary

Due to the huge gap in the care of patients with osteoporosis and fragility fractures, we aimed to explore the effectiveness of the osteoporosis liaison service (OLS) in osteoporosis care. We found that OLS can improve osteoporosis care, including increasing medication compliance, increasing calcium/vitamin D/protein intake, and reducing fall rate.

Introduction

A significant gap exists in the care of patients with osteoporosis and fragility fractures. This study aimed to evaluate 1-year outcomes of an osteoporosis liaison service (OLS) program that includes two independent components: medication management services (MMS) to improve medication adherence and fracture liaison services (FLS) for secondary prevention.

Methods

Patients with new hip fracture or untreated vertebral fractures enrolled in the FLS program (n = 600), and those with osteoporosis medication management issues but not necessarily fragility fractures enrolled in the MMS program (n = 499) were included. To evaluate outcomes, care coordinators assessed baseline items adapted from the 13 Best Practices Framework (BPF) standards of the International Osteoporosis Foundation, with telephone follow-up every 4 months for 1 year.

Results

Mean age of this cohort was 76.2 ± 10.3 years, 78.8% were female. After 1-year participation in the program, all patients had received bone mineral density tests, and medication adherence for the entire cohort at 12 months was 91.9 ± 19.6%, with significant improvement in fall rates (23.4% reduction), exercise rates (16.8% increase), calcium intake (26.5% increase), vitamin D intake (26.4% increase), and adequate protein intake (17.3% increase) (all p < 0.05). After 1-year OLS program, the overall rates of mortality, incident fracture, and falls were 6.6%, 4.0%, and 24.3%, respectively.

Conclusions

The OLS program is associated with improved osteoporosis care, including increased medication adherence, calcium/vitamin D and protein intake, and reduced fall rate.

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Author information

Authors and Affiliations

  1. Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan

    C.-B. Chang, W.-J. Huang & D.-C. Chan

  2. Department of Medicine, Chu-Tung Branch, National Taiwan University Hospital, Zhudong Township, Hsinchu County, Taiwan

    C.-B. Chang

  3. Department of Orthopaedics, National Taiwan University Hospital, Taipei, Taiwan

    R.-S. Yang

  4. Natioanl Taiwan University College of Medicine, Taipei, Taiwan

    L.-Y. Chang

  5. Department of Family Medicine, Bei-Hu Branch, National Taiwan University Hospital, Taipei, Taiwan

    J.-K. Peng

  6. Superintendent Office, Far Eastern Polyclinic of Far Eastern Medical Foundation, Taipei, Taiwan

    K.-S. Tsai

  7. Department of Orthopaedics, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan

    T.-H. Yang

  8. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    D.-C. Chan

  9. Superintendent Office, Hsin-Chu Branch, National Taiwan University Hospital, No. 25, Ln442, Jingguo Rd., Hsinchu City, 30059, Taiwan

    D.-C. Chan

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  1. C.-B. Chang
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  3. L.-Y. Chang
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  4. J.-K. Peng
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  5. K.-S. Tsai
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  6. W.-J. Huang
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  7. T.-H. Yang
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  8. D.-C. Chan
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Corresponding author

Correspondence to D.-C. Chan.

Ethics declarations

Ethics approval

This study was approved by the Research Ethics Committee at National Taiwan University Hospital (NTUH) (FLS 201311048RINC, and MMS 201406077RINA) and performed in accordance with the ethical standards in the 1964 Declaration of Helsinki.

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None.

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The work was majorly performed in the Department of Geriatrics and Gerontology, National Taiwan University Hospital.

Supplementary Information

Supplementary Figure 1

Compliance with 13 BPF standards from Fracture Liaison Service (FLS) and Medication Management Services (MMS) FLS: Fracture Liaison Service; MMS: Medication Management Service (PDF 162 kb)

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Chang, CB., Yang, RS., Chang, LY. et al. One-year outcomes of an osteoporosis liaison services program initiated within a healthcare system. Osteoporos Int 32, 2163–2172 (2021). https://doi.org/10.1007/s00198-021-05859-w

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  • DOI: https://doi.org/10.1007/s00198-021-05859-w

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