The effectiveness of fracture liaison services in patients with hip fractures: A systematic review and meta-analysis of randomized controlled trials

Chengli Yan; Yuyu Chen; Jia Cao; Kai Fang; Lifang Shao; Yaping Luo; Lili Yang

doi:10.1016/j.heliyon.2023.e20838

The effectiveness of fracture liaison services in patients with hip fractures: A systematic review and meta-analysis of randomized controlled trials

Heliyon. 2023 Oct 10;9(10):e20838. doi: 10.1016/j.heliyon.2023.e20838. eCollection 2023 Oct.

Authors

Chengli Yan¹, Yuyu Chen¹, Jia Cao², Kai Fang³, Lifang Shao¹, Yaping Luo¹, Lili Yang¹

Affiliations

¹ Department of Nursing, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China.
² Nursing Department, Dazhou Central Hospital, Sichuan, China.
³ Department of Information, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China.

Abstract

Background: In recent years, fracture liaison services (FLS) have been applied for hip fractures; however, their effectiveness remains uncertain.

Objective: To evaluate the effectiveness of FLS in patients with hip fractures.

Design: A systematic review and meta-analysis of randomized controlled trials.

Data sources: Embase, PubMed, Cochrane Library, Ebsco, Ovid, Web of Science, Medline, CNKI, Wangfang, and Vip were searched from their date of inception to March 2023. Two researchers screened the literature based on the inclusion and exclusion criteria, evaluated the quality, extracted data, and conducted a meta-analysis using ReviewManager 5.4.

Results: After screening, 12 randomised controlled trials (RCT) including 2136 patients were used in the meta-analysis. The primary outcomes were hip function rate of recurrent fracture, medication adherence, and degree of weakness. FLS improved hip function in patients with hip fractures [MD = 9.37, 95 % CI (7.69, 11.06), P < 0.0001], P < 0.0001], medication adherence [OR = 10.59, 95 % CI (1.64, 68.41), P＜0.0001], degree of weakness [MD = -1.45, 95%CI (-1.68，-1.23), P＜0.0001], and reduced the rate of recurrent fractures [OR = 0.60, 95 % CI (0.44, 0.82).

Conclusion: Implementation of the FLS management model was beneficial for patients with hip fractures. It can positively impact the prognosis of patients with hip fractures by improving hip function, reducing the rate of recurrent fractures, and improving medication adherence and degree of weakness.

Keywords: Fracture liaison service; Hip fracture; Meta-analysis.