Evidence map›Paper›PMID 40993438›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2025

Adherence to secondary fracture prevention is associated with reduced risk of subsequent fractures.

Åshild Bjørnerem, Jashar Khoshkhabari, Ann Kristin Hansen, Tove Tveitan Borgen, Frede Frihagen, Lene Bergendal Solberg, Tone Kristin Omsland, Frida Igland Nissen

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Review
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

8 authors.

Åshild BjørneremDepartment of Clinical Medicine, UiT - The Arctic University of Norway, N-9037, Tromsø, Norway. ashild.bjornerem@uit.no.ORCID http://orcid.org/0000-0002-3123-2950
Jashar KhoshkhabariDepartment of Clinical Medicine, UiT - The Arctic University of Norway, N-9037, Tromsø, Norway.
Ann Kristin HansenDepartment of Clinical Medicine, UiT - The Arctic University of Norway, N-9037, Tromsø, Norway.
Tove Tveitan BorgenDepartment of Rheumatology, Vestre Viken Hospital Trust, Drammen Hospital, Drammen, Norway.
Frede FrihagenDepartment of Orthopaedic Surgery, Østfold Hospital Trust, N-1712, Grålum, Norway.
Lene Bergendal SolbergDivision of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Tone Kristin OmslandDepartment of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
Frida Igland NissenDepartment of Clinical Medicine, UiT - The Arctic University of Norway, N-9037, Tromsø, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Attenders to fracture liaison services in a quality assessment study of 1936 women and men ≥ 50 years had 20% lower risk of subsequent fractures and 33% lower mortality than non-attenders. Patient's who were adherent to AOD after 12 months had a 49% lower risk of fractures than non-adherent patients. PURPOSE: Secondary fracture prevention rates are low in Norway and internationally. To overcome the existing treatment gap, fracture liaison services (FLS) are recommended. The study aimed to assess impact of FLS on fracture rates and mortality among attenders versus non-attenders, and patients adherent versus non-adherent to AOD.

methodsThis single-center sub-study of the Norwegian Capture the Fracture Initiative included 1936 women and men ≥ 50 years of age with an index fracture of any type during 2015-2018. We estimated hazard ratios (HR) for subsequent fractures and mortality in 1041 attenders versus 895 non-attenders to the FLS, and 427 patients who were adherent versus 174 patients who were non-adherent to anti-osteoporotic drugs (AOD) 12 months after treatment initiation.

resultsDuring a median 3.5-years observation (range 0.5 to 6.3), attenders had a 20% lower risk of subsequent fractures of any type (HR 0.80; 95% CI 0.64-0.999) and 33% lower mortality (HR 0.67; 95% CI 0.51-0.89) than non-attenders. Patients who were adherent to AOD after 12 months had a 49% lower risk of subsequent fractures than non-adherent patients (HR 0.51; 95% CI 0.35-0.72), but no difference in mortality was shown. Models were adjusted for age, sex, body mass index, smoking, prior fracture, and index hip fracture.

conclusionThese results confirm that patients who were able and willing to attend FLS had lower risk of subsequent fractures and mortality than non-attenders. Patients who were adherent to AOD had lower risk of subsequent fractures than non-adherent patients, emphasizing the importance of adherence in secondary fracture prevention.

Indexed as

Bone Density Conservation AgentsOsteoporotic FracturesSecondary PreventionAgedAged, 80 and overFemaleHumansMaleMiddle AgedNorwayOsteoporosisRisk AssessmentBone Density Conservation AgentsFracture liaison servicesMenMortalitySecondary fracture preventionSubsequent fractureWomen

Identifiers

PMID40993438
PMCPMC12628403

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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.