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http://hdl.handle.net/1942/29078
Title: | Challenges and opportunities to improve fracture liaison service attendance: fracture registration and patient characteristics and motivations | Authors: | van den Berg, P. van Haard, P. M. M. GEUSENS, Piet VAN DEN BERGH, Joop Schweitzer, D. H. |
Issue Date: | 2019 | Publisher: | SPRINGER LONDON LTD | Source: | OSTEOPOROSIS INTERNATIONAL, 30(8), p. 1597-1606 | Abstract: | A Summary This questionnaire-based study evaluated the reasons for attendance or non-attendance at the fracture liaison service in patients with a recent fracture. Frailty, male sex, living alone, and low education were associated with non-attendance, and the information perceived by the patient was associated with attendance. Introduction The purpose of this study was to evaluate hospital registration- and patient-related factors associated with attendance or non-attendance to the Fracture Liaison Service (FLS). Methods Out of 1728 consecutive patients registered with a recent fracture at hospital entry, and after exclusion of 440 patients because of death, residence in a nursing home, already on osteoporosis treatment, or recent DXA, 1288 received an FLS invitation. We evaluated the hospital registration of fractures at entry and exit of the hospital. A questionnaire was sent to all invited patients to evaluate factors related to non-attendance (including age, gender, frailty, living alone, income, education, extrinsic motivations (impact of perceived information) and intrinsic motivations (patient's own perceived views and opinions) and to attendance (personal impact of clinical professionals' advice). Results There were 278 more hospital exit codes than entry codes. Of the 1288 invited patients, 745 returned analyzable questionnaires (537 attenders and 208 non-attenders). Non-attendance was associated with male gender (OR: 2.08, 95% CI: 1.35, 3.21), frailty (OR: 1.62, CI: 1.08, 2.45), living alone (OR:2.05, CI: 1.48, 2.85), low education (OR: 1.82, CI: 1.27, 2.63), not interested in bone strength (OR: 1.85, CI: 1.33, 2.63), and being unaware of increased subsequent fracture risk (OR: 1.75, CI: 1.08, 2.86). Information perceived by the patient was significantly associated with attendance (OR: 3.32, CI: 1.75, 6.27). Conclusion Fracture entry registration inaccuracies, male gender, frailty, living alone, having low general education, or low interest in bone health and subsequent fracture risk were independently associated with FLS non-attendance. Adequately perceived advice (to have a bone densitometry and attend the FLS) was strongly associated with FLS attendance. | Notes: | [van den Berg, P.] Reinier de Graaf Hosp, Dept Orthoped & Traumasurg, Fracture Liaison Serv, Delft, Netherlands. [van Haard, P. M. M.] Reinier Graaf Hosp, Dept Med Labs, Assoc Clin Chem, Delft, Netherlands. [Geusens, P. P.; van den Bergh, J. P.] Maastricht Univ, Dept Internal Med, Subdiv Rheumatol, Med Ctr, Maastricht, Netherlands. [Geusens, P. P.] Hasselt Univ, Hasselt, Belgium. [van den Bergh, J. P.] Maastricht Univ, Med Ctr, Dept Internal Med, VieCuri Med Ctr Noord Limburg, Maastricht, Netherlands. [Schweitzer, D. H.] Reinier Graaf Hosp, Dept Internal Med & Endocrinol, Delft, Netherlands. | Keywords: | Attendance; FLS; Non-attendance;Attendance; FLS; Non-attendance | Document URI: | http://hdl.handle.net/1942/29078 | ISSN: | 0937-941X | e-ISSN: | 1433-2965 | DOI: | 10.1007/s00198-019-05016-4 | ISI #: | 000477904900006 | Rights: | International Osteoporosis Foundation and National Osteoporosis Foundation 2019 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2020 |
Appears in Collections: | Research publications |
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