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Erschienen in:

01.12.2021 | Original Article

Fracture liaison service model: treatment persistence 5 years later

verfasst von: Antonio Naranjo, Amparo Molina, Adrián Quevedo, Francisco J. Rubiño, Fernando Sánchez-Alonso, Carlos Rodríguez-Lozano, Soledad Ojeda

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2021

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Abstract

Summary

We analyzed the long-term persistence of treatment in a FLS. During follow-up, 15.2% of patients had a refracture and 23.8% died. At the 5-year checkup, 74% had started treatment (associated with female sex, previous use of bisphosphonate, and referral to an osteoporosis clinic). Persistence at 1 and 5 years was 70.6% and 46.5%, respectively.

Introduction

To analyze the long-term persistence of treatment in a fracture liaison service (FLS).

Methods

Patients ≥ 50 years with a fragility fracture attended between 2012 and 2016 who were recommended for treatment to prevent new fractures were included. Baseline data included demographics, type of fracture, previous treatment, and FRAX® items. Five years later, patient records were reviewed and the following data were collected: [1] survival; [2] refracture; [3] initiation of treatment, persistence, and medication possession ratio (MPR) > 80%.

Results

We included 888 patients, mean age 75 years, 83% women, and mean follow-up 56 months. During follow-up, 135 patients (15.2%) had a refracture (109 major fractures, 50 hip refractures) and 212 patients died (23.8%); at the 5-year checkup, 657 patients (74%) had started some type of treatment. Factors associated with the start of treatment were female sex (OR 2.10; 95% CI: 1.42–3.11), previous use of bisphosphonate (OR 3.91; 95% CI: 2.23–6.86), and referral to an osteoporosis clinic (OR 1.46; 95% CI: 1.02–2.07). Persistence decreased from 70.6% at 12 months to 46.5% at 60 months. An MPR > 80% was confirmed in 449 patients, 68.3% of whom were under treatment. A total of 521 and 447 patients received treatment for at least 24 and 36 months, respectively (79.3% and 68.0% of those who started treatment).

Conclusions

Patients with fragility fractures attended at an FLS showed optimal long-term persistence of treatment. These data can help healthcare managers better calculate the cost-effectiveness of implementing the FLS model.

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Titel: Fracture liaison service model: treatment persistence 5 years later
verfasst von: Antonio Naranjo
Amparo Molina
Adrián Quevedo
Francisco J. Rubiño
Fernando Sánchez-Alonso
Carlos Rodríguez-Lozano
Soledad Ojeda
Publikationsdatum: 01.12.2021
Verlag: Springer London
Erschienen in: Archives of Osteoporosis / Ausgabe 1/2021
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-021-00925-6

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