Rehabilitation Division, Tottori University Hospital, Tottori, 683-8504, Japan.
School of Health Science, Faculty of Medicine, Tottori University, Tottori, Japan.
Osteoporos Int. 2021 Mar;32(3):495-503. doi: 10.1007/s00198-021-05825-6. Epub 2021 Jan 23.
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.
This study aimed to determine the efficiency of coordinator-based osteoporosis intervention in fragility fracture patients during a 2-year period.
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.
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.
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.
本研究旨在确定为期 2 年的基于协调员的骨质疏松症干预对脆性骨折患者的效率。
一项前瞻性干预随机对照研究于 2015 年 1 月至 2017 年 3 月在 7 家医疗设施进行。将绝经后妇女和 50 岁以上的脆性骨折男性随机分为协调员干预（LI；70 例）和无干预（非-LI；71 例）组。比较两组患者登记后 3 个月、6 个月、1 年和 2 年的骨质疏松症治疗率、骨质疏松症治疗持续率、跌倒率、骨折发生率和骨密度测量率。在每个检查期采用非参数检验分析数据。
LI 组骨质疏松症治疗起始率明显高于非-LI 组（85.7%比 71.8%；p = 0.04）。LI 组在登记时（90.0%比 69.0%；p = 0.00）和登记后 6 个月（50.0%比 29.6%；p = 0.01）的骨密度评估实施率明显高于非-LI 组，但在登记后 1 年或 2 年时则没有。此外，两组间跌倒或骨折发生率无显著差异。
脆性骨折的协调员干预措施提高了骨密度评估的实施率和治疗率，并在骨折后早期提高了治疗的持续率。研究结果表明，联络干预可能有助于骨折和骨质疏松症医生评估骨质疏松症，并开始和继续骨质疏松症药物治疗。
