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Effectiveness of a minimal resource fracture liaison service
Department of Orthopaedic Surgery, Skaraborg Hospital, Skövde, Sweden / Geriatric Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden / Center for Bone Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
University of Skövde, School of Bioscience. University of Skövde, Health and Education. (Fysisk aktivitet, idrott, hälsa och digital teknik, Physical Activity, Sports, Health and Digital Technology)ORCID iD: 0000-0002-6549-086X
Geriatric Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden / Center for Bone Research at the Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
2016 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 27, no 11, 3165-3175 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The purpose of this study was to investigate if a 2-year intervention with a minimal resource fracture liaison service (FLS) was associated with increased investigation and medical treatment and if treatment was related to reduced re-fracture risk.

METHODS: The FLS started in 2013 using existing secretaries (without an FLS coordinator) at the emergency department and orthopaedic wards to identify risk patients. All patients older than 50 years of age with a fractured hip, vertebra, shoulder, wrist or pelvis were followed during 2013-2014 (n = 2713) and compared with their historic counterparts in 2011-2012 (n = 2616) at the same hospital. Re-fractures were X-ray verified. A time-dependent adjusted (for age, sex, previous fracture, index fracture type, prevalent treatment, comorbidity and secondary osteoporosis) Cox model was used.

RESULTS: The minimal resource FLS increased the proportion of DXA-investigated patients after fracture from 7.6 to 39.6 % (p < 0.001) and the treatment rate after fracture from 12.6 to 31.8 %, which is well in line with FLS types using the conventional coordinator model. Treated patients had a 51 % lower risk of any re-fracture than untreated patients (HR 0.49, 95 % CI 0.37-0.65 p < 0.001).

CONCLUSIONS: We found that our minimal resource FLS was effective in increasing investigation and treatment, in line with conventional coordinator-based services, and that treated patients had a 51 % reduced risk of new fractures, indicating that also non-coordinator based fracture liaison services can improve secondary prevention of fractures.

Place, publisher, year, edition, pages
2016. Vol. 27, no 11, 3165-3175 p.
Keyword [en]
Efficiency, FLS, Fracture, Fracture liaison service, Osteoporosis
National Category
Orthopedics
Identifiers
URN: urn:nbn:se:his:diva-13013DOI: 10.1007/s00198-016-3643-2ISI: 000388954600006PubMedID: 27230521Scopus ID: 2-s2.0-84970046075OAI: oai:DiVA.org:his-13013DiVA: diva2:1033813
Available from: 2016-10-10 Created: 2016-10-10 Last updated: 2017-11-30Bibliographically approved

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