Efficiency of coordinator-based osteoporosis intervention in fragility fracture patients:​ a prospective randomized trial

Osaki, M.; Okuda, R.; Saeki, Y.; Okano, T.; Tsuda, K.; Nakamura, T.; Morio, Y.; Nagashima, H.; Hagino, H.

Affiliations

¹Rehabilitation Division, Tottori University Hospital, Tottori 683-8504, Japan

²School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan

³Orthopedic Surgery Hospital Ward, Tottori University Hospital, Tottori, Japan

⁴Department of Orthopedic Surgery, San-in Rosai Hospital, Tottori, Japan

⁵Department of Orthopedic Surgery, Saiseikai Sakaiminato General Hospital, Tottori, Japan

⁶Department of Orthopedic Surgery, Hakuai Hospital, Tottori, Japan

⁷Department of Orthopedic Surgery, Misasa Onsen Hospital, Tottori, Japan

⁸Department of Orthopedic Surgery, Tottori University, Tottori, Japan

Abstract and keywords

Summary: We examined the effectiveness of coordinators’ interventions to prevent secondary fractures in patients with fragility fractures. These coordinator-based interventions improved bone density assessment implementation and treatment rates, and enhanced treatment persistence rates in the early stages following fractures.

Introduction: This study aimed to determine the efficiency of coordinator-based osteoporosis intervention in fragility fracture patients during a 2-year period.

Methods: A prospective intervention randomized control study was conducted at seven medical facilities from January 2015 to March 2017. Postmenopausal women and men over 50 years old with fragility fractures were randomly divided into the coordinator intervention (LI; 70 patients) and without intervention (non-LI; 71 patients) groups. The osteoporosis treatment rate, osteoporosis treatment persistence rate, fall rate, fracture incidence rate, and bone density measurement rate 3 months, 6 months, 1 year, and 2 years after registration were compared between the two groups. Non-parametric tests were used to analyze data at each inspection period.

Results: The osteoporosis treatment initiation rate was significantly higher in the LI group than in the non-LI group (85.7% vs. 71.8%; p = 0.04). The LI group had significantly higher bone density assessment implementation rates than the non-LI group at the time of registration (90.0% vs. 69.0%; p = 0.00) and 6 months after registration (50.0% vs. 29.6%; p = 0.01), but not 1 or 2 years after registration. In addition, no significant differences in fall or fracture incidence rates were found between the two groups.

Conclusion: The coordinator-based interventions for fragility fractures improved bone density assessment implementation and treatment rates and enhanced treatment persistence rates in the early stages following bone fractures. The findings suggest that liaison intervention may help both fracture and osteoporosis physicians for the evaluation of osteoporosis and initiation and continuation of osteoporosis medication.

Keywords: Anti-osteoporosis treatment; Bone density assessment; Fall rate; Fracture liaison service; Secondary fracture prevention

Links

DOI: 10.1007/s00198-021-05825-6

PubMed: 33483796

WoS: 000609959000001

History

Received: 2020-10-11

Accepted: 2021-01-04

Online: 2021-01-23

Cited Works (4)

Year	Entry
2000	Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA III, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. April 2000;15(4):721-739.
2001	NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. February 14, 2001;285(6):785-795.
2020	González-Quevedo D, Bautista-Enrique D, Pérez-del-Río V, Bravo-Bardají M, García-de-Quevedo D, Tamimi I. Fracture liaison service and mortality in elderly hip fracture patients: a prospective cohort study. Osteoporos Int. January 2020;31(1):77-84.
2014	Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, Dawson‐Hughes B. The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res. November 2014;29(11):2520-2526.