Evidence map›Paper›PMID 33813663›Full record

ArticleArchives of osteoporosis2021

Fracture liaison service model: treatment persistence 5 years later.

Antonio Naranjo, Amparo Molina, Adrián Quevedo, Francisco J Rubiño, Fernando Sánchez-Alonso, Carlos Rodríguez-Lozano, Soledad Ojeda

Abstract read
PubMed Publisher
In one paragraph

Article in Archives of osteoporosis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Antonio NaranjoRheumatology, Hospital Universitario de Gran Canaria Dr. Negrín, Barranco de la Ballena, 35011, Las Palmas, Spain. anarher@gobiernodecanarias.org.ORCID https://orcid.org/0000-0002-2013-6664
Amparo MolinaRheumatology, Hospital Universitario de Gran Canaria Dr. Negrín, Barranco de la Ballena, 35011, Las Palmas, Spain.
Adrián QuevedoRheumatology, Hospital Universitario de Gran Canaria Dr. Negrín, Barranco de la Ballena, 35011, Las Palmas, Spain.
Francisco J RubiñoRheumatology, Hospital Universitario de Gran Canaria Dr. Negrín, Barranco de la Ballena, 35011, Las Palmas, Spain.
Fernando Sánchez-AlonsoInvestigation Unit, Spanish Society of Rheumatology, Madrid, Spain.
Carlos Rodríguez-LozanoRheumatology, Hospital Universitario de Gran Canaria Dr. Negrín, Barranco de la Ballena, 35011, Las Palmas, Spain.
Soledad OjedaRheumatology, Hospital Universitario de Gran Canaria Dr. Negrín, Barranco de la Ballena, 35011, Las Palmas, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We analyzed the long-term persistence of treatment in a FLS. During follow-up, 15.2% of patients had a refracture and 23.8% died. At the 5-year checkup, 74% had started treatment (associated with female sex, previous use of bisphosphonate, and referral to an osteoporosis clinic). Persistence at 1 and 5 years was 70.6% and 46.5%, respectively.

introductionTo analyze the long-term persistence of treatment in a fracture liaison service (FLS).

methodsPatients ≥ 50 years with a fragility fracture attended between 2012 and 2016 who were recommended for treatment to prevent new fractures were included. Baseline data included demographics, type of fracture, previous treatment, and FRAX® items. Five years later, patient records were reviewed and the following data were collected: [1] survival; [2] refracture; [3] initiation of treatment, persistence, and medication possession ratio (MPR) > 80%.

resultsWe included 888 patients, mean age 75 years, 83% women, and mean follow-up 56 months. During follow-up, 135 patients (15.2%) had a refracture (109 major fractures, 50 hip refractures) and 212 patients died (23.8%); at the 5-year checkup, 657 patients (74%) had started some type of treatment. Factors associated with the start of treatment were female sex (OR 2.10; 95% CI: 1.42-3.11), previous use of bisphosphonate (OR 3.91; 95% CI: 2.23-6.86), and referral to an osteoporosis clinic (OR 1.46; 95% CI: 1.02-2.07). Persistence decreased from 70.6% at 12 months to 46.5% at 60 months. An MPR > 80% was confirmed in 449 patients, 68.3% of whom were under treatment. A total of 521 and 447 patients received treatment for at least 24 and 36 months, respectively (79.3% and 68.0% of those who started treatment).

conclusionsPatients with fragility fractures attended at an FLS showed optimal long-term persistence of treatment. These data can help healthcare managers better calculate the cost-effectiveness of implementing the FLS model.

Indexed as

Bone Density Conservation AgentsOsteoporosisOsteoporotic FracturesAgedDiphosphonatesFemaleHumansMaleSecondary PreventionBone Density Conservation AgentsDiphosphonatesAdherenceBisphosphonateFractureFracture liaison serviceOsteoporosisPersistence

Identifiers

PMID33813663

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.