University of New South Wales Rural Clinical School, Coffs Harbour, Australia.
Coffs Harbour Health Campus, Coffs Harbour, Australia.
Arch Osteoporos. 2020 Jul 29;15(1):118. doi: 10.1007/s11657-020-00787-4.
Fracture liaison services (FLSs) were established to address the well-recognised gap in bone health management after a fragility fracture. However, it is unclear what happens to patients after discharge from an FLS. Our study suggests FLSs should include a patient bone health education session and a follow-up telephone call 12-18 months post-discharge to optimise management, in particular, to assess therapy adherence and to reinforce bone health advice.
While fracture liaison services (FLSs) have improved bone health management following fragility fracture, it is unclear what happens to patients following discharge from these services. We sought to determine patient self-reported medication adherence and the need for bone-specific health advice ≥ 12 months following discharge from one of the first FLSs in Australia.
Patients were contacted by telephone ≥ 12 months following discharge from the Coffs Fracture Prevention Clinic (CFPC)/FLS to determine if the patient was still taking prescribed bone protective therapy (BPT). Bone health advice was provided, if appropriate, during the telephone interview.
Of the 516 consecutive patients seen in CFPC from July 2012-December 2018, 326 (63.2%) were assessed and discharged from the clinic. One hundred and two patients (19.8%) were lost to follow-up/uncontactable. Of 190 patients commenced on BPT at CFPC and who were discharged ≥ 12 months prior, 141 (74.2%) self-reported adherence with BPT. Bone health advice was required during the telephone call in 60/190 (31.6%) of these patients. Of the 141 adherent patients, 40 (28.4%) had attended a bone health education session, compared to 4/49 (8.2%) patients in the non-adherent group (p = 0.004).
At 19 months following discharge from our FLS, self-reported adherence with treatment was 74%. One bone health education session at baseline was associated with increased treatment adherence. At time of telephone contact, one third of patients required further advice to optimise bone health.
骨折联络服务（FLS）改善了脆性骨折后骨健康管理，但患者从这些服务中出院后会发生什么情况尚不清楚。我们旨在确定患者在从澳大利亚首个 FLS 之一出院后≥12 个月时的自我报告药物依从性和对骨特异性健康建议的需求。
从 2012 年 7 月至 2018 年 12 月，在科夫斯骨折预防诊所（CFPC）/FLS 接受治疗并出院≥12 个月的患者通过电话进行联系，以确定患者是否仍在服用规定的骨保护治疗（BPT）。如果需要，将在电话访谈中提供骨健康建议。
在 2012 年 7 月至 2018 年 12 月期间在 CFPC 就诊的 516 例连续患者中，有 326 例（63.2%）接受评估并从诊所出院。102 例（19.8%）失访/无法联系。在 190 例在 CFPC 开始接受 BPT 并出院≥12 个月的患者中，有 141 例（74.2%）自我报告坚持使用 BPT。在这些患者中，有 60/190（31.6%）名患者需要在电话通话中提供骨健康建议。在 141 名依从性患者中，有 40 名（28.4%）参加了骨健康教育课程，而在不依从性组的 49 名患者中仅有 4 名（8.2%）（p=0.004）。
在从我们的 FLS 出院 19 个月后，自我报告的治疗依从性为 74%。基线时的一次骨健康教育课程与增加治疗依从性有关。在电话联系时，三分之一的患者需要进一步的建议以优化骨健康。
