在医疗系统内启动骨质疏松症联络服务计划的一年结果。

One-year outcomes of an osteoporosis liaison services program initiated within a healthcare system.

机构信息

Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.

Department of Medicine, Chu-Tung Branch, National Taiwan University Hospital, Zhudong Township, Hsinchu County, Taiwan.

出版信息

Osteoporos Int. 2021 Nov;32(11):2163-2172. doi: 10.1007/s00198-021-05859-w. Epub 2021 May 6.

DOI:10.1007/s00198-021-05859-w

PMID:33954815

Abstract

UNLABELLED

Due to the huge gap in the care of patients with osteoporosis and fragility fractures, we aimed to explore the effectiveness of the osteoporosis liaison service (OLS) in osteoporosis care. We found that OLS can improve osteoporosis care, including increasing medication compliance, increasing calcium/vitamin D/protein intake, and reducing fall rate.

INTRODUCTION

A significant gap exists in the care of patients with osteoporosis and fragility fractures. This study aimed to evaluate 1-year outcomes of an osteoporosis liaison service (OLS) program that includes two independent components: medication management services (MMS) to improve medication adherence and fracture liaison services (FLS) for secondary prevention.

METHODS

Patients with new hip fracture or untreated vertebral fractures enrolled in the FLS program (n = 600), and those with osteoporosis medication management issues but not necessarily fragility fractures enrolled in the MMS program (n = 499) were included. To evaluate outcomes, care coordinators assessed baseline items adapted from the 13 Best Practices Framework (BPF) standards of the International Osteoporosis Foundation, with telephone follow-up every 4 months for 1 year.

RESULTS

Mean age of this cohort was 76.2 ± 10.3 years, 78.8% were female. After 1-year participation in the program, all patients had received bone mineral density tests, and medication adherence for the entire cohort at 12 months was 91.9 ± 19.6%, with significant improvement in fall rates (23.4% reduction), exercise rates (16.8% increase), calcium intake (26.5% increase), vitamin D intake (26.4% increase), and adequate protein intake (17.3% increase) (all p < 0.05). After 1-year OLS program, the overall rates of mortality, incident fracture, and falls were 6.6%, 4.0%, and 24.3%, respectively.

CONCLUSIONS

The OLS program is associated with improved osteoporosis care, including increased medication adherence, calcium/vitamin D and protein intake, and reduced fall rate.

摘要

目的

由于骨质疏松症患者和脆性骨折患者的护理存在巨大差距，我们旨在探索骨质疏松症联络服务（OLS）在骨质疏松症护理中的有效性。我们发现 OLS 可以改善骨质疏松症护理，包括提高药物依从性、增加钙/维生素 D/蛋白质摄入以及降低跌倒率。

引言

骨质疏松症患者和脆性骨折患者的护理存在显著差距。本研究旨在评估包括药物管理服务（MMS）以提高药物依从性和骨折联络服务（FLS）以进行二级预防的独立的 OLS 项目的 1 年结果。

方法

纳入新髋部骨折或未治疗的椎体骨折的 FLS 项目患者（n=600）和存在骨质疏松症药物管理问题但不一定有脆性骨折的 MMS 项目患者（n=499）。为了评估结果，护理协调员评估了国际骨质疏松基金会的 13 项最佳实践框架（BPF）标准改编的基线项目，在 1 年内每 4 个月进行一次电话随访。

结果

该队列的平均年龄为 76.2±10.3 岁，78.8%为女性。在参与该项目 1 年后，所有患者均接受了骨密度测试，整个队列在 12 个月时的药物依从性为 91.9±19.6%，跌倒率显著降低（降低 23.4%），运动率（增加 16.8%），钙摄入量（增加 26.5%），维生素 D 摄入量（增加 26.4%）和足够的蛋白质摄入（增加 17.3%）（均 p<0.05）。在 OLS 项目 1 年后，总体死亡率、新发骨折和跌倒率分别为 6.6%、4.0%和 24.3%。