Skip to main content
Erschienen in: Archives of Osteoporosis 1/2018

01.12.2018 | Original Article

Improvement in the primary and secondary prevention of osteoporosis by a Fracture Liaison Service: feedback from a single French center care pathway

verfasst von: Arthur Vrignaud, Simon Pelletier, Emmanuelle Dernis, Yvon Moui, Bénédicte Haettich

Erschienen in: Archives of Osteoporosis | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Abstract

Summary

Osteoporosis is responsible for fragility fractures, thus causing significant morbidity and mortality. This study shows that care pathways, such as Le Mans General Hospital Fracture Liaison Service, are useful and efficient in improving the prevention of osteoporosis and of its consequences.

Introduction

Osteoporosis is a major public health concern, causing significant morbidity and mortality. Care pathways, called Fracture Liaison Services, have demonstrated their utility in preventing osteoporosis-associated morbidity and mortality. The aim of this study was to analyze the activity of one such care pathway.

Methods

This was a retrospective, observational, cohort study, in which 272 patients who had fragility fractures between January 2012 and December 2016 were included. Screening of the medical records and data analyses were performed to characterize the population and the medical care received related to osteoporosis, and to compare these data with those of another study carried out from January 2010 to January 2011 on 54 patients in the same Fracture Liaison Service.

Results

There was no statistically significant difference between the two cohorts concerning their demographic characteristics, with 92.3% women and a mean age of 68.7 in our cohort. Secondary prevention was improved, as shown by a reduction in the number of vertebral fractures detected by systematic assessment and fewer low-energy fractures. This study also demonstrated a decline in the percentage of patients with a first-degree parental history of hip fracture and a trend towards a decline in the rate of those having vitamin D insufficiency.

Conclusions

Communication with patients and healthcare professionals through the Fracture Liaison Service was beneficial for patients in terms of fracture prevention. This study supports the development of similar care pathways in other healthcare institutions.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Melton LJ (2003) Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res 18(6):1139–1141CrossRef Melton LJ (2003) Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res 18(6):1139–1141CrossRef
2.
Zurück zum Zitat Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136CrossRef Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136CrossRef
3.
Zurück zum Zitat Svedbom A, Hernlund E, Ivergård M, Compston J, Cooper C, Stenmark J et al (2013) Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 8(137):137CrossRef Svedbom A, Hernlund E, Ivergård M, Compston J, Cooper C, Stenmark J et al (2013) Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 8(137):137CrossRef
4.
Zurück zum Zitat Solomon DH, Patrick AR, Schousboe J, Losina E (2014) The potential economic benefits of improved post-fracture care: a cost-effectiveness analysis of a fracture liaison service in the US healthcare system. J Bone Miner Res 29(7):1667–1674CrossRef Solomon DH, Patrick AR, Schousboe J, Losina E (2014) The potential economic benefits of improved post-fracture care: a cost-effectiveness analysis of a fracture liaison service in the US healthcare system. J Bone Miner Res 29(7):1667–1674CrossRef
5.
Zurück zum Zitat Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. BMJ 307(6914):1248–1250CrossRef Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. BMJ 307(6914):1248–1250CrossRef
6.
Zurück zum Zitat Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353(9156):878–882CrossRef Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353(9156):878–882CrossRef
7.
Zurück zum Zitat Lindsay R, Burge RT, Strauss DM (2005) One year outcomes and costs following a vertebral fracture. Osteoporos Int 16(1):78–85CrossRef Lindsay R, Burge RT, Strauss DM (2005) One year outcomes and costs following a vertebral fracture. Osteoporos Int 16(1):78–85CrossRef
8.
Zurück zum Zitat Silverman SL (2005) Quality-of-life issues in osteoporosis. Curr Rheumatol Rep 7(1):39–45CrossRef Silverman SL (2005) Quality-of-life issues in osteoporosis. Curr Rheumatol Rep 7(1):39–45CrossRef
9.
Zurück zum Zitat Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733CrossRef Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733CrossRef
10.
Zurück zum Zitat Caliri A, De Filippis L, Bagnato GL, Bagnato GF (2007) Osteoporotic fractures: mortality and quality of life. Panminerva Med 49(1):21–27PubMed Caliri A, De Filippis L, Bagnato GL, Bagnato GF (2007) Osteoporotic fractures: mortality and quality of life. Panminerva Med 49(1):21–27PubMed
11.
Zurück zum Zitat Curran D, Maravic M, Kiefer P, Tochon V, Fardellone P (2010) Epidemiology of osteoporosis-related fractures in France: a literature review. Joint Bone Spine 77(6):546–551CrossRef Curran D, Maravic M, Kiefer P, Tochon V, Fardellone P (2010) Epidemiology of osteoporosis-related fractures in France: a literature review. Joint Bone Spine 77(6):546–551CrossRef
12.
Zurück zum Zitat Rapport au ministre chargé de la sécurité sociale et au Parlement sur l’évolution des charges et des produits de l’Assurance Maladie au titre de 2016 (loi du 13 août 2004). II.5 Prévenir les réhospitalisations par une meilleure prise en charge après une fracture pour fragilité osseuse : 54–61 Rapport au ministre chargé de la sécurité sociale et au Parlement sur l’évolution des charges et des produits de l’Assurance Maladie au titre de 2016 (loi du 13 août 2004). II.5 Prévenir les réhospitalisations par une meilleure prise en charge après une fracture pour fragilité osseuse : 54–61
13.
Zurück zum Zitat Bouxsein ML, Kaufman J, Tosi L, Cummings S, Lane J, Johnell O (2004) Recommendations for optimal care of the fragility fracture patient to reduce the risk of future fracture. J Am Acad Orthop Surg 12(6):385–395CrossRef Bouxsein ML, Kaufman J, Tosi L, Cummings S, Lane J, Johnell O (2004) Recommendations for optimal care of the fragility fracture patient to reduce the risk of future fracture. J Am Acad Orthop Surg 12(6):385–395CrossRef
14.
Zurück zum Zitat Freedman KB, Kaplan FS, Bilker WB, Strom BL, Lowe RA (2000) Treatment of osteoporosis: are physicians missing an opportunity? J Bone Joint Surg Am 82-A(8):1063–1070CrossRef Freedman KB, Kaplan FS, Bilker WB, Strom BL, Lowe RA (2000) Treatment of osteoporosis: are physicians missing an opportunity? J Bone Joint Surg Am 82-A(8):1063–1070CrossRef
15.
Zurück zum Zitat Siris ES, Bilezikian JP, Rubin MR, Black DM, Bockman RS, Bone HG, Hochberg MC, McClung MR, Schnitzer TJ (2003) Pins and plaster aren’t enough: a call for the evaluation and treatment of patients with osteoporotic fractures. J Clin Endocrinol Metab 88(8):3482–3486CrossRef Siris ES, Bilezikian JP, Rubin MR, Black DM, Bockman RS, Bone HG, Hochberg MC, McClung MR, Schnitzer TJ (2003) Pins and plaster aren’t enough: a call for the evaluation and treatment of patients with osteoporotic fractures. J Clin Endocrinol Metab 88(8):3482–3486CrossRef
16.
Zurück zum Zitat Lespessailles E, Cotté F-E, Roux C, Fardellone P, Mercier F, Gaudin AF (2009) Prevalence and features of osteoporosis in the French general population: the Instant study. Joint Bone Spine 76(4):394–400CrossRef Lespessailles E, Cotté F-E, Roux C, Fardellone P, Mercier F, Gaudin AF (2009) Prevalence and features of osteoporosis in the French general population: the Instant study. Joint Bone Spine 76(4):394–400CrossRef
17.
Zurück zum Zitat Sorbi R, Aghamirsalim MR (2012) Knowledge of orthopaedic surgeons in managing patients with fragility fracture. Int Orthop 36(6):1275–1279CrossRef Sorbi R, Aghamirsalim MR (2012) Knowledge of orthopaedic surgeons in managing patients with fragility fracture. Int Orthop 36(6):1275–1279CrossRef
18.
Zurück zum Zitat Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15(4):721–739CrossRef Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15(4):721–739CrossRef
19.
Zurück zum Zitat Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767CrossRef Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767CrossRef
20.
Zurück zum Zitat Van Staa TP, Leufkens HGM, Cooper C (2002) Does a fracture at one site predict later fractures at other sites? A British cohort study. Osteoporos Int 13(8):624–629CrossRef Van Staa TP, Leufkens HGM, Cooper C (2002) Does a fracture at one site predict later fractures at other sites? A British cohort study. Osteoporos Int 13(8):624–629CrossRef
21.
Zurück zum Zitat Yong JHE, Masucci L, Hoch JS, Sujic R, Beaton D (2016) Cost-effectiveness of a fracture liaison service--a real-world evaluation after 6 years of service provision. Osteoporos Int 27(1):231–240CrossRef Yong JHE, Masucci L, Hoch JS, Sujic R, Beaton D (2016) Cost-effectiveness of a fracture liaison service--a real-world evaluation after 6 years of service provision. Osteoporos Int 27(1):231–240CrossRef
22.
Zurück zum Zitat 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(12):1028–1034CrossRef 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(12):1028–1034CrossRef
23.
Zurück zum Zitat Judge A, Javaid MK, Leal J, Hawley S, Drew S, Sheard S et al (2016) Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and costeffectiveness study within a region of England. Southampton (UK): NIHR Journals LibraryCrossRef Judge A, Javaid MK, Leal J, Hawley S, Drew S, Sheard S et al (2016) Models of care for the delivery of secondary fracture prevention after hip fracture: a health service cost, clinical outcomes and costeffectiveness study within a region of England. Southampton (UK): NIHR Journals LibraryCrossRef
24.
Zurück zum Zitat Leal J, Gray AM, Hawley S, Prieto-Alhambra D, Delmestri A, Arden NK, Cooper C, Javaid MK, Judge A, and the REFReSH Study Group (2017) Cost-effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: a population-based study. J Bone Miner Res 32(2):203–211CrossRef Leal J, Gray AM, Hawley S, Prieto-Alhambra D, Delmestri A, Arden NK, Cooper C, Javaid MK, Judge A, and the REFReSH Study Group (2017) Cost-effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: a population-based study. J Bone Miner Res 32(2):203–211CrossRef
25.
Zurück zum Zitat Majumdar SR, Lier DA, Hanley DA, Juby AG, Beaupre LA, STOP-PRIHS Team (2017) Economic evaluation of a population-based osteoporosis intervention for outpatients with non-traumatic non-hip fractures: the “Catch a Break” 1i [type C] FLS. Osteoporos Int 28(6):1965–1977CrossRef Majumdar SR, Lier DA, Hanley DA, Juby AG, Beaupre LA, STOP-PRIHS Team (2017) Economic evaluation of a population-based osteoporosis intervention for outpatients with non-traumatic non-hip fractures: the “Catch a Break” 1i [type C] FLS. Osteoporos Int 28(6):1965–1977CrossRef
26.
Zurück zum Zitat Walters S, Khan T, Ong T, Sahota O (2017) Fracture liaison services: improving outcomes for patients with osteoporosis. Clin Interv Aging 12:117–127CrossRef Walters S, Khan T, Ong T, Sahota O (2017) Fracture liaison services: improving outcomes for patients with osteoporosis. Clin Interv Aging 12:117–127CrossRef
27.
Zurück zum Zitat Conway GS (2000) Premature ovarian failure. Br Med Bull 56(3):643–649CrossRef Conway GS (2000) Premature ovarian failure. Br Med Bull 56(3):643–649CrossRef
28.
Zurück zum Zitat Goswami D, Conway GS (2007) Premature ovarian failure. Horm Res 68(4):196–202PubMed Goswami D, Conway GS (2007) Premature ovarian failure. Horm Res 68(4):196–202PubMed
Metadaten
Titel
Improvement in the primary and secondary prevention of osteoporosis by a Fracture Liaison Service: feedback from a single French center care pathway
verfasst von
Arthur Vrignaud
Simon Pelletier
Emmanuelle Dernis
Yvon Moui
Bénédicte Haettich
Publikationsdatum
01.12.2018
Verlag
Springer London
Erschienen in
Archives of Osteoporosis / Ausgabe 1/2018
Print ISSN: 1862-3522
Elektronische ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-018-0523-8

Weitere Artikel der Ausgabe 1/2018

Archives of Osteoporosis 1/2018 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.