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Title: | Fracture liaison services: do they reduce fracture rates? | Authors: | de Bruin, Irma J. A. Wyers, Caroline E. VAN DEN BERGH, Joop GEUSENS, Piet |
Issue Date: | 2017 | Publisher: | SAGE PUBLICATIONS LTD | Source: | THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE, 9(7), p. 157-164 | Abstract: | The fracture liaison service (FLS) care is considered the most appropriate organizational approach for secondary fracture prevention. We performed a literature search to evaluate to what extent the introduction of a FLS reduced subsequent fracture rates. We identified five studies that compared subsequent fracture rates. These studies varied in study design, proportion of women, baseline and subsequent fracture type [vertebral fracture (VF), non-VF (NVF) or hip fractures], duration of follow-up, response rates of attending the FLS, as well as variables included in adjusted analyses (age, sex, baseline fracture, time dependency). In two studies comparing hospitals with and without a FLS, the adjusted hazard ratio (HR) for subsequent fractures was significantly lower in the FLS hospitals (HR: 0.84 during the first year, 0.44 during the second year for subsequent NVFs after baseline NVF, and 0.67 during the third year for subsequent VFs + NVFs after baseline VFs + NVFs). When comparing fracture rates before (pre-FLS) and after (post-FLS) introduction of a FLS, the adjusted HR for subsequent NVFs after baseline NVF was significantly lower in the post-FLS group after 2 years in one study (HR = 0.65) and nonsignificant in another study for subsequent hip fractures after baseline hip fracture. One study comparing pre-FLS and post-FLS with a follow-up of less than a year did not demonstrate a significant difference in subsequent fracture risk. In conclusion, only five FLS studies with heterogeneous study designs are available, three of them reported a lower subsequent fracture rate related to FLS care. Larger and long-term studies will be needed to further quantify the effect of FLS care on subsequent fracture risk. | Notes: | [van den Bergh, Joop P. W.; Geusens, Piet P. M. M.] Hasselt Univ, Biomed Res Ctr, Agoralaan Gebouw D, Diepenbeek, Belgium. [Geusens, Piet P. M. M.] Maastricht Univ, Med Ctr, Dept Internal Med, Subdiv Rheumatol,CAPHRI, POB 616, NL-6200 MD Maastricht, Netherlands. [de Bruin, Irma J. A.; Wyers, Caroline E.; van den Bergh, Joop P. W.] VieCuri Med Ctr, Dept Internal Med, Venlo, Netherlands. [de Bruin, Irma J. A.; Wyers, Caroline E.; van den Bergh, Joop P. W.] Maastricht Univ, Med Ctr, Dept Internal Med, NUTRIM Sch Nutr & Translat Res Metab, Maastricht, Netherlands. Dept Internal Med, VieCuri Med Ctr, Venlo, Netherlands. Maastricht Univ Med Ctr MUMC, NUTRIM Sch Nutr & Translat Res Metab, Dept Internal Med, Maastricht, Netherlands. Hasselt Univ, Biomed Res Ctr, Agoralaan gebouw, Diepenbeek, Belgium. Hasselt Univ, Biomed Res Ctr, Agoralaan gebouw, Diepenbeek, Belgium. Maastricht Univ Med Ctr MUMC, Dept Internal Med, Subdivis Rheumatol, CAPHRI, Maastricht, Netherlands. | Keywords: | fracture liaison service; fragility fracture; subsequent fractures; re-fracture rate;fracture liaison service; fragility fracture; subsequent fractures; re-fracture rate | Document URI: | http://hdl.handle.net/1942/26371 | ISSN: | 1759-720X | e-ISSN: | 1759-7218 | DOI: | 10.1177/175972x017706464 | ISI #: | 000405022100001 | Rights: | © The Author(s), 2017. Reprints and permissions: http://www.sagepub.co.uk/ journalsPermissions.nav | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
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