An evaluation of an enhanced fracture liaison service as the optimal model for secondary prevention of osteoporosis

OBJECTIVE: To assess secondary preventative therapy among postmenopausal female inpatients (aged 75 years and over) receiving surgical management for a fractured neck of femur using two service delivery models. DESIGN: Practice in two fracture units was audited and compared using the NICE guidelines (TA 87) as an audit standard. SETTING: Two fracture units: one with a fracture liaison service and one without. PARTICIPANTS: Postmenopausal female inpatients (aged 75 years and over) receiving surgical management for a fractured neck of femur. MAIN OUTCOME MEASURES: Rate of anti-resorptive treatment and rate of enquiry into risk factors. RESULTS: There was a significantly higher rate of anti-resorptive treatment (90.5% compared to 60.9% with a difference of 29.6%, p < 0.001) and enquiry into risk factors (83% compared to 7%) in the unit with a fracture liaison service. CONCLUSIONS: We propose that a hospital-based enhanced fracture liaison service may result in higher osteoporosis treatment rates among postmenopausal hospitalized hip fracture patients aged 75 years and over.