Fracture liaison service programs may lead to effective osteoporosis treatment
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Implementation of a fracture liaison service program may lead to effective treatment for osteoporosis among patients with fragility fractures of the hip, according to results.
Gershon Zinger, MD, MS, and colleagues randomly assigned 200 patients older than age 50 years with a fragility fracture of the hip to either a control group (n=99) or intervention group (n=101). Researchers provided patients in the control group with a letter at the time of discharge that encouraged their primary care physicians to start medication for osteoporosis.
“The other group had four interventions,” Zinger told Healio Orthopedics. “This included printed information on what is osteoporosis and why it is important to treat, they had a DEXA scan done while in the hospital, they had a sheet with a specific treatment recommendation to give to their family doctor and, finally, the research assistant would call once a month for 4 months to encourage them or the family to start treatment.”
Researchers evaluated levels of calcium, albumin, creatinine, electrolytes, complete blood count and thyroid-stimulating hormones, and calculated creatinine clearance. Researchers considered whether the patient was on correct treatment at 4 months from the fracture as the primary outcome measure.
The final analysis was based on 180 patients, with 20 patients removed from the study, according to researchers. At 4 months post-injury, results showed 6.2% and 77.1% of patients in the control and intervention groups, respectively, were on correct medication. Researchers did not find any differences in treatment rates between age groups or gender, with similar results found in multivariate analysis controlling for age and gender.
“After over 20 years of effective treatment for osteoporosis, the challenge remains getting patients started on medication,” Zinger said. “We show that a motivated orthopedic surgeon does not need to change an entire system to get effective results. With a part-time dedicated assistant, an intervention program can be started to improve bone health.” – by Casey Tingle
Reference:
Zinger GM, et al. ePaper 015. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
Disclosure: Zinger reports he receives research support from Amgen Co.