Fracture Liaison Service for Hip Fractures: Is It A Game Changer?

Isr Med Assoc J. 2021 Aug;23(8):490-493.

Abstract

Background: Osteoporosis is a common medical condition in older ages. A devastating result of osteoporosis may be a hip fracture with up to 30% mortality rate in one year. The compliance rate of osteoporotic medication following a hip fracture is 20% in the western world.

Objectives: To evaluate the impact of the fracture liaison service (FLS) model in the orthopedic department on patient compliance following hip fracture.

Methods: We performed a retrospective review of all patients with hip fracture who were involved with FLS. We collected data regarding kidney function, calcium levels, parathyroid hormone levels, and vitamin D levels at admission. We educated the patient and family, started vitamin D and calcium supplementation and recommended osteoporotic medical treatment. We phoned the patient 6-12 weeks following the fracture to ensure treatment initiation.

Results: From June 2018 to June 2019 we identified 166 patients with hip fracture who completed at least one year of follow-up. Over 75% of the patients had low vitamin D levels and 22% had low calcium levels at admission. Nine patients (5%) died at median of 109 days. Following our intervention, 161 patients (96%) were discharged with a specific osteoporotic treatment recommendation; 121 (73%) received medication for osteoporosis on average of < 3 months after surgery. We recommended on injectable medications; however, 51 (42%) were treated with oral biphsophonate.

Conclusions: FLS improved the compliance rate of osteoporotic medical treatment and should be a clinical routine in every medical center.

MeSH terms

  • Aged
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / classification
  • Calcium / administration & dosage*
  • Dietary Supplements
  • Drug Therapy, Combination
  • Female
  • Hip Fractures* / mortality
  • Hip Fractures* / prevention & control
  • Hip Fractures* / surgery
  • Humans
  • Israel / epidemiology
  • Male
  • Mortality
  • Orthopedic Procedures / statistics & numerical data
  • Osteoporosis* / blood
  • Osteoporosis* / complications
  • Osteoporosis* / drug therapy
  • Osteoporosis* / epidemiology
  • Osteoporotic Fractures* / mortality
  • Osteoporotic Fractures* / prevention & control
  • Osteoporotic Fractures* / surgery
  • Postoperative Period*
  • Retrospective Studies
  • Secondary Prevention* / methods
  • Secondary Prevention* / organization & administration
  • Vitamin D / administration & dosage*
  • Vitamin D / blood

Substances

  • Bone Density Conservation Agents
  • Vitamin D
  • Calcium