A fracture prevention service reduces further fractures two years after incident minimal trauma fracture

Int J Rheum Dis. 2014 Feb;17(2):195-203. doi: 10.1111/1756-185X.12101. Epub 2013 May 28.

Abstract

Aim: To evaluate the impact of a fracture prevention clinic service on initiation of treatment, continuing treatment and subsequent minimal trauma fractures (MTF).

Method: Participants were people aged 50 and over, with a minimal trauma fracture presenting to the Emergency Department (ED) in a large tertiary referral hospital in New South Wales, Australia, between February 2007 and March 2009. A cohort of patients who attended a Fracture Prevention Clinic (clinic group) were compared with a cohort who did not attend the clinic (non-clinic group). A telephone questionnaire was conducted with participants or their carers between December 2010 and April 2011 at least 12 months post-fracture presentation. Questionnaire items included demographics, fracture types, osteoporosis treatment, recurrent fractures and smoking and dietary habits. Data were compared using chi-squared test for categorical variables and Student's t-test or Mann-Whitney U-test for continuous variables.

Results: Two hundred and fourteen clinic attendees and 220 non-clinic attendees were surveyed between 12 and 40 months (mean 24 months) post-initial fracture. New fracture rates were lower in the clinic group (5.1%) than the non-clinic group (16.4%, P < 0.001). Treatment rates for bone fragility were higher in the clinic group (81.3%) than in the non-clinic group (54.1%, P < 0.001) with 66.8% of the clinic group and 34.1% of the non-clinic group on a bisphosphonate or strontium ranelate at the time of the survey (P < 0.001).

Conclusion: Patients managed by a fracture prevention clinic service following a MTF have fewer new fractures and are more likely to be on treatment for bone fragility.

Keywords: fracture liaison service; osteoporosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Density Conservation Agents / therapeutic use
  • Chi-Square Distribution
  • Diet / adverse effects
  • Feeding Behavior
  • Female
  • Fractures, Bone / diagnosis
  • Fractures, Bone / epidemiology
  • Fractures, Bone / prevention & control*
  • Humans
  • Incidence
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • New South Wales / epidemiology
  • Osteoporosis / drug therapy
  • Osteoporosis / epidemiology
  • Osteoporotic Fractures / diagnosis
  • Osteoporotic Fractures / epidemiology
  • Osteoporotic Fractures / prevention & control
  • Patient Readmission
  • Preventive Health Services*
  • Prospective Studies
  • Risk Factors
  • Secondary Prevention
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Surveys and Questionnaires
  • Tertiary Care Centers
  • Time Factors
  • Treatment Outcome

Substances

  • Bone Density Conservation Agents