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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/12019

Title: Implementation of osteoporosis guidelines: a survey of five large fracture liaison services in the Netherlands
Authors: Huntjens, K. M. B.
van Geel, T. A. C. M.
Blonk, M. C.
Hegeman, J. H.
van der Elst, M.
Willems, P.
Winkens, B.
Brink, P.
van Helden, S. H.
Issue Date: 2011
Citation: OSTEOPOROSIS INTERNATIONAL, 22(7). p. 2129-2135
Abstract: Implementation of case findings according to guidelines for osteoporosis in fracture patients presenting at a Fracture Liaison Service (FLS) was evaluated. Despite one guideline, all FLSs differed in the performance of patient selection and prevalence of clinical risk factors (CRFs) indicating the need for more concrete and standardised guidelines. The aim of the study was to evaluate the implementation of case findings according to guidelines for osteoporosis in fracture patients presenting at FLSs in the Netherlands. Five FLSs were contacted to participate in this prospective study. Patients older than 50 years with a recent clinical fracture who were able and were willing to participate in fracture risk evaluation were included. Performance was evaluated by criteria for patient recruitment, patient characteristics, nurse time, evaluated clinical risk factors (CRFs), bone mineral density (BMD) and laboratory testing and results of CRFs and BMD are presented. Differences between FLSs were analysed for performance (by chi-square and Student's t test) and for prevalence of CRFs (by relative risks (RR)). All FLSs had a dedicated nurse spending 0.9 to 1.7 h per patient. During 39 to 58 months follow-up, 7,199 patients were evaluated (15 to 47 patients/centre/month; mean age, 67 years; 77% women). Major differences were found between FLSs in the performance of patient recruitment, evaluation of CRFs, BMD and laboratory testing, varying between 0% and 100%. The prevalence of CRFs and osteoporosis varied significantly between FLSs (RR between 1.7 and 37.0, depending on the risk factor). All five participating FLSs with a dedicated fracture nurse differed in the performance of patient selection, CRFs and in the prevalence of CRFs, indicating the need for more concrete and standardised guidelines to organise evaluation of patients at the time of fracture in daily practice.
Notes: [Huntjens, K. M. B.] Sch Publ Hlth & Primary Care Caphri, NL-6202 AZ Maastricht, Netherlands. [Huntjens, K. M. B.; Brink, P.] MUMC, Dept Trauma Surg, Maastricht, Netherlands. [van Geel, T. A. C. M.] Maastricht Univ, Dept Gen Practice Caphri, Maastricht, Netherlands. [Blonk, M. C.] Catharina Hosp, Dept Internal Med, Eindhoven, Netherlands. [Hegeman, J. H.] Ziekenhuisgrp Twente Almelo, Dept Surg, Almelo, Netherlands. [van der Elst, M.] Reinier de Graaf Gasthuis, Dept Surg, Delft, Netherlands. [Willems, P.] Maastricht Univ Med Ctr, Dept Orthopaed, Maastricht, Netherlands. [Winkens, B.] Maastricht Univ, Dept Methodol & Stat, Maastricht, Netherlands. [Geusens, P. P.] Maastricht Hasselt Univ, Dept Internal Med Subdiv Rheumatol, Biomed Res Inst, MUMC, Diepenbeek, Belgium. [van Helden, S. H.] Isala Klin, Dept Trauma Surg, Zwolle, Netherlands. k.huntjens@ah.unimaas.nl
URI: http://hdl.handle.net/1942/12019
DOI: 10.1007/s00198-010-1442-8
ISI #: 000291227700008
ISSN: 0937-941X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2012
Appears in Collections: Research publications

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