|Title:||Fracture liaison service model: treatment persistence 5 years later||Authors:||Naranjo Hernández, Antonio
Rubiño, Francisco J.
|UNESCO Clasification:||32 Ciencias médicas
Fracture Liaison Service
Osteoporosis, et al
|Issue Date:||2021||Journal:||Archives of Osteoporosis||Abstract:||Summary: We analyzed the long-term persistence of treatment in a FLS. During follow-up, 15.2% of patients had a refracture and 23.8% died. At the 5-year checkup, 74% had started treatment (associated with female sex, previous use of bisphosphonate, and referral to an osteoporosis clinic). Persistence at 1 and 5 years was 70.6% and 46.5%, respectively. Introduction: To analyze the long-term persistence of treatment in a fracture liaison service (FLS). Methods: Patients ≥ 50 years with a fragility fracture attended between 2012 and 2016 who were recommended for treatment to prevent new fractures were included. Baseline data included demographics, type of fracture, previous treatment, and FRAX® items. Five years later, patient records were reviewed and the following data were collected:  survival;  refracture;  initiation of treatment, persistence, and medication possession ratio (MPR) > 80%. Results: We included 888 patients, mean age 75 years, 83% women, and mean follow-up 56 months. During follow-up, 135 patients (15.2%) had a refracture (109 major fractures, 50 hip refractures) and 212 patients died (23.8%); at the 5-year checkup, 657 patients (74%) had started some type of treatment. Factors associated with the start of treatment were female sex (OR 2.10; 95% CI: 1.42–3.11), previous use of bisphosphonate (OR 3.91; 95% CI: 2.23–6.86), and referral to an osteoporosis clinic (OR 1.46; 95% CI: 1.02–2.07). Persistence decreased from 70.6% at 12 months to 46.5% at 60 months. An MPR > 80% was confirmed in 449 patients, 68.3% of whom were under treatment. A total of 521 and 447 patients received treatment for at least 24 and 36 months, respectively (79.3% and 68.0% of those who started treatment). Conclusions: Patients with fragility fractures attended at an FLS showed optimal long-term persistence of treatment. These data can help healthcare managers better calculate the cost-effectiveness of implementing the FLS model.||URI:||http://hdl.handle.net/10553/106923||ISSN:||1862-3522||DOI:||10.1007/s11657-021-00925-6||Source:||Archives of Osteoporosis [ISSN 1862-3522], v. 16 (1), 60, (Diciembre 2021)|
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