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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/16697

Title: Optimizing fracture prevention: the fracture liaison service, an observational study
Authors: Eekman, D. A.
van Helden, S. H.
Huisman, A. M.
Verhaar, H. J. J.
Bultink, I. E. M.
Lips, P.
Lems, W. F.
Issue Date: 2014
Citation: OSTEOPOROSIS INTERNATIONAL, 25 (2), p. 701-709
Abstract: Summary: The response rate to the invitation to the fracture liaison service and reasons for non-response were evaluated in 2,207 fragility fracture patients. Fifty-one percent responded; non-responders were most often not interested (38 %) or were hip fracture patients. After 1 year of treatment, 88 % was still persistent and 2 % had a new fracture. Introduction: To increase the percentage of elderly fracture patients undergoing a dual energy x-ray absorptiometry (DXA) measurement, and to investigate why some patients did not respond to invitation to our fracture liaison service (FLS). Methods: In four Dutch hospitals, fracture patients ≥50 years were invited through a written or personal invitation at the surgical outpatient department, 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 2,207 patients who 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.
Notes: Eekman, DA (reprint author), Vrije Univ Amsterdam Med Ctr, Dept Rheumatol, POB 7057, NL-1007 MB Amsterdam, Netherlands. d.eekman@vumc.nl; s.h.van.helden@isala.nl; m.huisman@sgf.nl; H.J.J.Verhaar@umcutrecht.nl; iem.bultink@vumc.nl; piet.geusens@scarlet.be; p.lips@vumc.nl; wf.lems@vumc.nl
URI: http://hdl.handle.net/1942/16697
DOI: 10.1007/s00198-013-2481-8
ISI #: 000330981100034
ISSN: 0937-941X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2015
Appears in Collections: Research publications

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