Characterization of fracture liaison service non-responders after invitation by home visits and questionnaires

van den Berg, P.; van Haard, P. M. M.; Geusens, P. P.; van den Bergh, J. P.; Schweitzer, D. H.

Affiliations

¹Department of Orthopedics and Trauma surgery, Fracture Liaison Service, Reinier de Graaf Hospital, Delft, The Netherlands

²Department of Medical Laboratories, Association of Clinical Chemistry, Reinier the Graaf Hospital, Delft, The Netherlands

³Department of Internal Medicine, Subdivision Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands

⁴Hasselt University, Hasselt, Belgium

⁵Department of Internal Medicine, VieCuri Medical Centre, Venlo, The Netherlands

⁶Department of Internal Medicine and Endocrinology, Reinier the Graaf Hospital, Delft, The Netherlands

Abstract and keywords

Summary: This study aimed to gain insight in specific characteristics and beliefs of FLS non-responders.

Introduction: The proportion of non-responding fracture liaison service (FLS) invitees is high but characteristics of FLS non-responders are unknown.

Methods: We contacted FLS non-responders by telephone to consent with home visit (HV) and to fill in a questionnaire or, if HV was refused, to receive a questionnaire by post (Q), to gain insight in beliefs on fracture cause and subsequent fracture risk.

Results: Out of 716 FLS invitees, 510 attended, nine declined, and 197 did not respond. Of these non-responders, 181 patients were consecutively traced and phoned until 50 consented with HV. Forty-two declined HV but consented with Q. Excluded were eight Q-consenters in whom no choice was offered (either HV or Q) and 81 patients who declined any proposition (non-HV|Q). 62% HV and Q could recall the FLS invitation letter. The fracture cause was differently believed between HV and Q; the fall (96% versus 79%, p = .02), bad physical condition (36% versus 2%, p = .0001), dizziness or imbalance (24% versus Q 7%, p = .03), osteoporosis (16% versus 2%, p = .02), and increased fracture risk (26% versus 17%, NS). Age ≥ 70, woman, and major fracture were significantly associated with HV consent compared to Q (OR 2.7, 2.5, and 2.4, respectively) and HV compared to non-HV|Q (OR 16.8, 5.3, and 6.1).

Conclusion: FLS non-responders consider fracture risk as low. Note, 50 patients (about 25%) consented with a home visit after one telephone call, mainly older women with a major fracture. This non-responder subgroup with high subsequent fracture risk is therefore approachable for secondary fracture prevention.

Keywords: FLS; Home visit; Non-respondence; Non-attendance; Osteoporosis; Questionnaire

Links

DOI: 10.1007/s00198-020-05442-9

PubMed: 32405912

WoS: 000532629400001

History

Received: 2020-02-11

Accepted: 2020-04-29

Online: 2020-05-13

Cited Works (3)

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