ECTS2013 Poster Presentations Osteoporosis: treatment (64 abstracts)
Optimizing fracture prevention: the fracture liaison service, an observational study
Danielle Eekman 1 , Sven van Helden 2 , Margriet Huisman 3 , Harald Verhaar 4 , Irene Bultink 1 , Piet Geusens 5, , Paul Lips 1 & Willem Lems 1
1VU University Medical Center, Amsterdam, The Netherlands; 2Isala Clinics, Zwolle, The Netherlands; 3Sint Franciscus Gasthuis, Rotterdam, The Netherlands; 4University Medical Center Utrecht, Utrecht, The Netherlands; 5University Hospital, Maastricht, The Netherlands; 6University Hasselt, Hasselt, Belgium.
Objective: Increase the percentage of elderly fracture patients undergoing a dual energy X-ray absorptiometry (DXA) measurement, and investigate why some patients did not respond to invitation to our fracture liaison service (FLS).
Materials and methods: In four Dutch hospitals, fracture patients ≥50 years were invited for a DXA measurement and visit to our FLS. Patients who did not respond, were contacted by telephone. In patients diagnosed with osteoporosis, treatment was started. Patients were contacted every 3 months during 1 year to assess drug persistence and the occurrence of subsequent fractures.
Results: Of the 2207 patients that were invited: 50.6% responded. Most frequent reasons for not responding included: not interested (38%), already screened/under treatment for osteoporosis (15.7%), physically unable to attend the clinic (11.5%) and death (5.2%).
Hip fracture patients responded less frequently (29%) while patients with a wrist (60%), or ankle fracture (65.2%) were more likely to visit the clinic.
In 337 responding patients, osteoporosis was diagnosed and treatment was initiated. After 12 months of follow-up, 88% of the patients were still persistent with anti-osteoporosis therapy and only 2% suffered a subsequent clinical fracture.
Conclusion: In elderly fracture patients, the use of a FLS leads to an increased response rate, a high persistence to drug treatment, and a low rate of subsequent clinical fractures. Additional programs for hip fracture patients are required, as these patients have a low response rate.
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