Polyzois Makras1,2, George C Babis3, Efstathios Chronopoulos4,3, Theofilos Karachalios5, Konstantinos Kazakos6, Dionysios Paridis7, Michael Potoupnis8, Anastasios-Nektarios Tzavellas8,9, Christos Valkanis6, Christos Kosmidis4,10. 1. Department of Endocrinology and Diabetes and Department of Medical Research, 251 Hellenic Air Force General Hospital, 3 Kanellopoulou Str., 115 25, Goudi, Athens, Greece. pmakras@gmail.com. 2. Hellenic Society for the Study of Bone Metabolism, Athens, Greece. pmakras@gmail.com. 3. 2nd Department of Orthopaedic Surgery, Konstantopouleio Hospital, N. Ionia, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. 4. Hellenic Society for the Study of Bone Metabolism, Athens, Greece. 5. Orthopaedic Department, University General Hospital of Larissa, School of Health Sciences, University of Thessalia, Larissa, Greece. 6. Department of Orthopaedics, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece. 7. Orthopaedic Department, University General Hospital of Larissa, Larissa, Greece. 8. Academic Orthopaedic Unit of Papageorgiou General Hospital and Center of Orthopaedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece. 9. 2nd Department of Orthopaedic and Trauma Surgery, 424 Military General Hospital, Thessaloniki, Greece. 10. 1st Health District of Attica, Alexandras Health Centre, Athens, Greece.
Abstract
INTRODUCTION: We present the second implementation of a fracture liaison service (FLS) at a national level in Greece. METHODS: This was a multicenter prospective study, organized by the Hellenic Society for the Study of Bone Metabolism, aiming to investigate the tracking and outcome of patients with low-trauma fractures visiting four university orthopedic departments across the country. The primary endpoint was the participation rate of eligible patients with low-trauma fractures in the program within a time frame of 1 year. Secondary outcomes included the percentage of patients initiating osteoporosis treatment, adherence to treatment, and the percentage of patients experiencing subsequent fractures. A major difference with previous reports was the designed implication of the orthopedic surgeon managing the fracture. RESULTS: Among the 1350 eligible patients with major osteoporotic fractures, only 396 (29.3%; mean age 78.1 ± 11.6 years; female/male ratio: 4.4) agreed to participate, nearly all of the latter (n = 392) completing the study. With the exception of seven patients, all participants were receiving anti-osteoporotic treatment at the end of the study. Twelve new fractures were recorded at completion of the 12-month follow-up, which were all sustained in patients who either declined to receive anti-osteoporotic treatment or who discontinued treatment despite advice to the contrary. CONCLUSION: The participation rate remains low and needs improvement. However, we report herein that whenever the treating physician is involved in the FLS structure, patients are more easily convinced to complete the program, to receive anti-osteoporotic treatment, and to stay connected throughout with the outpatient clinic.
INTRODUCTION: We present the second implementation of a fracture liaison service (FLS) at a national level in Greece. METHODS: This was a multicenter prospective study, organized by the Hellenic Society for the Study of Bone Metabolism, aiming to investigate the tracking and outcome of patients with low-trauma fractures visiting four university orthopedic departments across the country. The primary endpoint was the participation rate of eligible patients with low-trauma fractures in the program within a time frame of 1 year. Secondary outcomes included the percentage of patients initiating osteoporosis treatment, adherence to treatment, and the percentage of patients experiencing subsequent fractures. A major difference with previous reports was the designed implication of the orthopedic surgeon managing the fracture. RESULTS: Among the 1350 eligible patients with major osteoporotic fractures, only 396 (29.3%; mean age 78.1 ± 11.6 years; female/male ratio: 4.4) agreed to participate, nearly all of the latter (n = 392) completing the study. With the exception of seven patients, all participants were receiving anti-osteoporotic treatment at the end of the study. Twelve new fractures were recorded at completion of the 12-month follow-up, which were all sustained in patients who either declined to receive anti-osteoporotic treatment or who discontinued treatment despite advice to the contrary. CONCLUSION: The participation rate remains low and needs improvement. However, we report herein that whenever the treating physician is involved in the FLS structure, patients are more easily convinced to complete the program, to receive anti-osteoporotic treatment, and to stay connected throughout with the outpatient clinic.