Ding Benjamin Tze Keong, Lim Hai Fon, Johari Fadzleen, Kunnasegaran Remesh
Department of Orthopaedic Surgery, Woodlands Health, 2 Yishun Central 2, Tower E, S768024, Singapore, Singapore.
Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, S768828, Singapore, Singapore.
Osteoporos Int. 2023 Feb;34(2):299-307. doi: 10.1007/s00198-022-06595-5. Epub 2022 Nov 21.
This study aims to evaluate the efficacy of an Orthopaedic Surgeon Led Osteoporosis Model of Care (OSLO-MoC) in improving care of patients with primary osteoporotic fractures. The OSLO-MOC has shown to be effective in improving osteoporotic medication initiation and compliance and reducing secondary fracture rates in patients.
This study aims to evaluate the efficacy of an Orthopaedic Surgeon Led Osteoporosis Model of Care (OSLO-MoC) as compared to a Case Manager Led Osteoporosis Model of Care (CMLO-MoC) in reducing early osteoporotic re-fracture rates and treatment compliance in patients.
This was a single centre, retrospective, comparative cohort study of all patients screened and treated for secondary osteoporotic fracture prevention from the 2008 to 2018 at an orthopaedic surgical unit. From the 2008 to 2013, patients were recruited under the CMLO-MoC and from 2014 to 2018, under the OSLO-MOC. Logistics regression analysis was used to identify significant predictors such as OSLO-MOC implementation, gender, ethnicity, marital status and education level for patient recruitment, treatment compliance and secondary fracture rates at 12-month follow-up.
Over a 10-year period, 7388 patients were screened of which 2855 patients were eligible for analysis. A total of 1234 patients were recruited under CMLO-MoC and 1621 patients under OSLO-MOC. Implementation of the OSLO-MOC was associated with greater patient recruitment, OR 1.26 (95%CI 1.06-1.49, P = 0.007). Of the 2855 patients recruited, OSLO-MOC implementation, OR 2.61 (95%CI 2.03-3.36, P < 0.001), and a higher level of education, OR 1.428 (95%CI 1.02-1.43, P = 0.037), were associated with improved compliance to medication at 12 months. OSLO-MOC implementation was the only factor associated with reduced risk of secondary fractures at 12 months, OR 0.14 (95%CI 0.03-0.66, P = 0.013).
The OSLO-MOC has shown to be effective in reducing the rate of re-fracture and osteoporotic medication initiation and compliance of patients.
IV.
本研究旨在评估由骨科医生主导的骨质疏松症护理模式（OSLO-MoC）在改善原发性骨质疏松性骨折患者护理方面的疗效。OSLO-MOC已被证明在改善骨质疏松症药物的起始使用和依从性以及降低患者继发性骨折发生率方面是有效的。
本研究旨在评估由骨科医生主导的骨质疏松症护理模式（OSLO-MoC）与由病例管理员主导的骨质疏松症护理模式（CMLO-MoC）相比，在降低患者早期骨质疏松性再骨折发生率和治疗依从性方面的疗效。
这是一项单中心、回顾性、比较队列研究，研究对象为2008年至2018年在一个骨科手术科室接受继发性骨质疏松性骨折预防筛查和治疗的所有患者。2008年至2013年，患者按照CMLO-MoC模式招募；2014年至2018年，按照OSLO-MOC模式招募。采用逻辑回归分析来确定12个月随访时患者招募、治疗依从性和继发性骨折发生率的显著预测因素，如OSLO-MOC的实施、性别、种族、婚姻状况和教育水平。
在10年期间，共筛查了7388例患者中的2855例符合分析条件。CMLO-MoC模式下共招募了1234例患者，OSLO-MOC模式下招募了1621例患者。OSLO-MOC的实施与更多的患者招募相关，比值比为1.26（95%置信区间1.06 - 1.49，P = 0.007）。在招募的2855例患者中，OSLO-MOC的实施，比值比为2.61（95%置信区间2.03 - 3.36，P < 0.001），以及较高的教育水平，比值比为1.428（95%置信区间1.02 - 1.43，P = 0.037），与12个月时药物依从性的改善相关。OSLO-MOC的实施是12个月时与继发性骨折风险降低相关的唯一因素，比值比为0.14（95%置信区间0.03 - 0.66，P = 0.013）。
OSLO-MOC已被证明在降低再骨折发生率以及提高患者骨质疏松症药物起始使用和依从性方面是有效的。
四级
