Cargando…

Evaluation of the Fracture Liaison Service within the Canadian Healthcare Setting

Previous studies evaluating fracture liaison service (FLS) programs have found them to be cost-effective, efficient, and reduce the risk of fracture. However, few studies have evaluated the clinical effectiveness of these programs. We compared the patient populations of those referred for osteoporos...

Descripción completa

Detalles Bibliográficos
Autores principales: Wong-Pack, Matthew, Naqvi, Nawazish, Ioannidis, George, Khalil, Ramy, Papaioannou, Alexandra, Adachi, Jonathan, Lau, Arthur N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115141/
https://www.ncbi.nlm.nih.gov/pubmed/32257097
http://dx.doi.org/10.1155/2020/6742604
_version_ 1783514037811675136
author Wong-Pack, Matthew
Naqvi, Nawazish
Ioannidis, George
Khalil, Ramy
Papaioannou, Alexandra
Adachi, Jonathan
Lau, Arthur N.
author_facet Wong-Pack, Matthew
Naqvi, Nawazish
Ioannidis, George
Khalil, Ramy
Papaioannou, Alexandra
Adachi, Jonathan
Lau, Arthur N.
author_sort Wong-Pack, Matthew
collection PubMed
description Previous studies evaluating fracture liaison service (FLS) programs have found them to be cost-effective, efficient, and reduce the risk of fracture. However, few studies have evaluated the clinical effectiveness of these programs. We compared the patient populations of those referred for osteoporosis management by FLS to those referred by primary care physicians (PCP), within the Canadian healthcare system in the province of Ontario. Specifically, we investigated if a referral from FLS is similarly effective as PCP at identifying patients at risk for future osteoporotic fractures and if osteoporosis therapies have been previously initiated. A retrospective chart review of patients assessed by a single Ontario rheumatology practice affiliated with FLS between January 1, 2014, and December 31, 2017, was performed identifying two groups: those referred by FLS within Hamilton and those referred by their PCP for osteoporosis management. Fracture risk of each patient was determined using FRAX. A total of 573 patients (n = 225 (FLS group) and n = 227 (PCP group)) were evaluated. Between the FLS and PCP groups, there were no significant differences in the absolute 10-year risk of a major osteoporotic fracture (15.6% (SD = 10.2) vs 15.3% (SD = 10.3)) and 10-year risk of hip fracture (4.7% (SD = 8.3) vs 4.7% (SD = 6.8)), respectively. 10.7% of patients referred by FLS and 40.5% of patients referred by their PCP were on osteoporosis medication prior to fracture. Our study suggests that referral from FLS is similarly effective as PCP at identifying patients at risk for future osteoporotic fractures, and clinically effective at identifying the care gap with the previous use of targeted osteoporosis therapies from referral from PCP being low and much lower in those referred by FLS. Interventional programs such as FLS can help close the treatment gap by providing appropriate care to patients that were not previously identified to be at risk for fracture by their primary care physician and initiate proper medical management.
format Online
Article
Text
id pubmed-7115141
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-71151412020-04-06 Evaluation of the Fracture Liaison Service within the Canadian Healthcare Setting Wong-Pack, Matthew Naqvi, Nawazish Ioannidis, George Khalil, Ramy Papaioannou, Alexandra Adachi, Jonathan Lau, Arthur N. J Osteoporos Research Article Previous studies evaluating fracture liaison service (FLS) programs have found them to be cost-effective, efficient, and reduce the risk of fracture. However, few studies have evaluated the clinical effectiveness of these programs. We compared the patient populations of those referred for osteoporosis management by FLS to those referred by primary care physicians (PCP), within the Canadian healthcare system in the province of Ontario. Specifically, we investigated if a referral from FLS is similarly effective as PCP at identifying patients at risk for future osteoporotic fractures and if osteoporosis therapies have been previously initiated. A retrospective chart review of patients assessed by a single Ontario rheumatology practice affiliated with FLS between January 1, 2014, and December 31, 2017, was performed identifying two groups: those referred by FLS within Hamilton and those referred by their PCP for osteoporosis management. Fracture risk of each patient was determined using FRAX. A total of 573 patients (n = 225 (FLS group) and n = 227 (PCP group)) were evaluated. Between the FLS and PCP groups, there were no significant differences in the absolute 10-year risk of a major osteoporotic fracture (15.6% (SD = 10.2) vs 15.3% (SD = 10.3)) and 10-year risk of hip fracture (4.7% (SD = 8.3) vs 4.7% (SD = 6.8)), respectively. 10.7% of patients referred by FLS and 40.5% of patients referred by their PCP were on osteoporosis medication prior to fracture. Our study suggests that referral from FLS is similarly effective as PCP at identifying patients at risk for future osteoporotic fractures, and clinically effective at identifying the care gap with the previous use of targeted osteoporosis therapies from referral from PCP being low and much lower in those referred by FLS. Interventional programs such as FLS can help close the treatment gap by providing appropriate care to patients that were not previously identified to be at risk for fracture by their primary care physician and initiate proper medical management. Hindawi 2020-03-21 /pmc/articles/PMC7115141/ /pubmed/32257097 http://dx.doi.org/10.1155/2020/6742604 Text en Copyright © 2020 Matthew Wong-Pack et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Wong-Pack, Matthew
Naqvi, Nawazish
Ioannidis, George
Khalil, Ramy
Papaioannou, Alexandra
Adachi, Jonathan
Lau, Arthur N.
Evaluation of the Fracture Liaison Service within the Canadian Healthcare Setting
title Evaluation of the Fracture Liaison Service within the Canadian Healthcare Setting
title_full Evaluation of the Fracture Liaison Service within the Canadian Healthcare Setting
title_fullStr Evaluation of the Fracture Liaison Service within the Canadian Healthcare Setting
title_full_unstemmed Evaluation of the Fracture Liaison Service within the Canadian Healthcare Setting
title_short Evaluation of the Fracture Liaison Service within the Canadian Healthcare Setting
title_sort evaluation of the fracture liaison service within the canadian healthcare setting
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115141/
https://www.ncbi.nlm.nih.gov/pubmed/32257097
http://dx.doi.org/10.1155/2020/6742604
work_keys_str_mv AT wongpackmatthew evaluationofthefractureliaisonservicewithinthecanadianhealthcaresetting
AT naqvinawazish evaluationofthefractureliaisonservicewithinthecanadianhealthcaresetting
AT ioannidisgeorge evaluationofthefractureliaisonservicewithinthecanadianhealthcaresetting
AT khalilramy evaluationofthefractureliaisonservicewithinthecanadianhealthcaresetting
AT papaioannoualexandra evaluationofthefractureliaisonservicewithinthecanadianhealthcaresetting
AT adachijonathan evaluationofthefractureliaisonservicewithinthecanadianhealthcaresetting
AT lauarthurn evaluationofthefractureliaisonservicewithinthecanadianhealthcaresetting