Fracture Liaison Service for Hip Fractures: Is It A Game Changer?

• Published in: The Israel Medical Association journal Vol. 23; no. 8; pp. 490 - 493
• Main Authors: Or, Omer, Fisher Negev, Tamar, Hadad, Vered, Shabtai, Ran, Katzir, Alona, Weil, Yotam, Liebergall, Meir
• Format: Journal Article
• Language: English
• Published: Israel 01-08-2021
• Subjects: Aged; Bone Density Conservation Agents - administration & dosage; Bone Density Conservation Agents - classification; Calcium - administration & dosage; Dietary Supplements; Drug Therapy, Combination; Female; Hip Fractures - mortality; Hip Fractures - prevention & control; Hip Fractures - surgery; Humans; Israel - epidemiology; Male; Mortality; Orthopedic Procedures - statistics & numerical data; Osteoporosis - blood; Osteoporosis - complications; Osteoporosis - drug therapy; Osteoporosis - epidemiology; Osteoporotic Fractures - mortality; Osteoporotic Fractures - prevention & control; Osteoporotic Fractures - surgery; Postoperative Period; Retrospective Studies; Secondary Prevention - methods; Secondary Prevention - organization & administration; Vitamin D - administration & dosage; Vitamin D - blood; Israel
• ISSN: 1565-1088

Osteoporosis is a common medical condition in older ages. A devastating result of osteoporosis may be a hip fracture with up to 30% mortality rate in one year. The compliance rate of osteoporotic medication following a hip fracture is 20% in the western world.
To evaluate the impact of the fracture liaison service (FLS) model in the orthopedic department on patient compliance following hip fracture.
We performed a retrospective review of all patients with hip fracture who were involved with FLS. We collected data regarding kidney function, calcium levels, parathyroid hormone levels, and vitamin D levels at admission. We educated the patient and family, started vitamin D and calcium supplementation and recommended osteoporotic medical treatment. We phoned the patient 6-12 weeks following the fracture to ensure treatment initiation.
From June 2018 to June 2019 we identified 166 patients with hip fracture who completed at least one year of follow-up. Over 75% of the patients had low vitamin D levels and 22% had low calcium levels at admission. Nine patients (5%) died at median of 109 days. Following our intervention, 161 patients (96%) were discharged with a specific osteoporotic treatment recommendation; 121 (73%) received medication for osteoporosis on average of < 3 months after surgery. We recommended on injectable medications; however, 51 (42%) were treated with oral biphsophonate.
FLS improved the compliance rate of osteoporotic medical treatment and should be a clinical routine in every medical center.