Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fractures
Background: Secondary fracture prevention is a well-defined treatment-gap within osteoporosis management. Fracture Liaison Service (FLS) coordinates the management and treatment of patients following a fragility fracture in order to close the care gap. We aim to assess the efficacy of the FLS initia...
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Elsevier
2025-09-01
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| Series: | Bone Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352187225000464 |
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| author | Orit Mazza Chemda Gluck Noa Menkes-Caspi Robyn Jacob Bornstein Hagay Amir Michael Bahar Amir Haim |
| author_facet | Orit Mazza Chemda Gluck Noa Menkes-Caspi Robyn Jacob Bornstein Hagay Amir Michael Bahar Amir Haim |
| author_sort | Orit Mazza |
| collection | DOAJ |
| description | Background: Secondary fracture prevention is a well-defined treatment-gap within osteoporosis management. Fracture Liaison Service (FLS) coordinates the management and treatment of patients following a fragility fracture in order to close the care gap. We aim to assess the efficacy of the FLS initiative in the management and treatment of patients following fragility hip fracture in the inpatient rehabilitation setting. Methods: This is a diagnostic, retrospective cohort study using a deidentified, electronic health record database. In the extraction process, patients with fragility hip fractures were identified. Patients after major trauma or malignancy were excluded. The prevalence of initiation and adherence to anti-osteoporotic treatments, including alendronate, risedronate, zoledronate, denosumab, romosozumab, and teriparatide, was compared between the rehabilitation FLS initiative patients and patients from other hospitals without FLS. Results: A total of 4,124 patients with fragility hip fractures were identified between 2017 and 2021. The FLS initiative showed significantly higher rates of treatment initiation, with 72.1 % of patients receiving pharmacological therapy following a hip fracture, compared to 45.1 % in hospitals without FLS (p < 0.001). Patients in the FLS group also demonstrated higher rates of good adherence and lower rates of poor adherence (p < 0.001). Denosumab was the most commonly prescribed anti-osteoporotic treatment within the FLS initiative. Conclusions: The FLS in the inpatient rehabilitation setting was found to be highly effective in improving time to treatment initiation and adherence rates to prescribe anti-osteoporosis therapy. These findings demonstrate the role of FLS in addressing the osteoporosis treatment gap following fragility hip fracture. |
| format | Article |
| id | doaj-art-7bb86a0da36f4483a1dee59ca8298c96 |
| institution | Kabale University |
| issn | 2352-1872 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Bone Reports |
| spelling | doaj-art-7bb86a0da36f4483a1dee59ca8298c962025-08-20T05:07:05ZengElsevierBone Reports2352-18722025-09-012610186910.1016/j.bonr.2025.101869Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fracturesOrit Mazza0Chemda Gluck1Noa Menkes-Caspi2Robyn Jacob Bornstein3Hagay Amir4Michael Bahar5Amir Haim6Loewenstein Rehabilitation Medical Center, Raanana, Israel; Clalit Health Services, Dan Petah-Tiqwa District, Israel; Corresponding author at: Loewenstein Rehabilitation Medical Center, Raanana, Israel.Loewenstein Rehabilitation Medical Center, Raanana, IsraelMental Health and Rehabilitation Research Center, Clalit Health Services, Petah-Tikva, IsraelLoewenstein Rehabilitation Medical Center, Raanana, IsraelLoewenstein Rehabilitation Medical Center, Raanana, IsraelGray Faculty of Medical & Health Sciences Tel Aviv University, Tel Aviv, Israel; Rabin Medical Center Beilinson Hospital, Petah Tikva, IsraelLoewenstein Rehabilitation Medical Center, Raanana, Israel; Gray Faculty of Medical & Health Sciences Tel Aviv University, Tel Aviv, IsraelBackground: Secondary fracture prevention is a well-defined treatment-gap within osteoporosis management. Fracture Liaison Service (FLS) coordinates the management and treatment of patients following a fragility fracture in order to close the care gap. We aim to assess the efficacy of the FLS initiative in the management and treatment of patients following fragility hip fracture in the inpatient rehabilitation setting. Methods: This is a diagnostic, retrospective cohort study using a deidentified, electronic health record database. In the extraction process, patients with fragility hip fractures were identified. Patients after major trauma or malignancy were excluded. The prevalence of initiation and adherence to anti-osteoporotic treatments, including alendronate, risedronate, zoledronate, denosumab, romosozumab, and teriparatide, was compared between the rehabilitation FLS initiative patients and patients from other hospitals without FLS. Results: A total of 4,124 patients with fragility hip fractures were identified between 2017 and 2021. The FLS initiative showed significantly higher rates of treatment initiation, with 72.1 % of patients receiving pharmacological therapy following a hip fracture, compared to 45.1 % in hospitals without FLS (p < 0.001). Patients in the FLS group also demonstrated higher rates of good adherence and lower rates of poor adherence (p < 0.001). Denosumab was the most commonly prescribed anti-osteoporotic treatment within the FLS initiative. Conclusions: The FLS in the inpatient rehabilitation setting was found to be highly effective in improving time to treatment initiation and adherence rates to prescribe anti-osteoporosis therapy. These findings demonstrate the role of FLS in addressing the osteoporosis treatment gap following fragility hip fracture.http://www.sciencedirect.com/science/article/pii/S2352187225000464Hip fracturesFracture liaison serviceOsteoporosisRehabilitation |
| spellingShingle | Orit Mazza Chemda Gluck Noa Menkes-Caspi Robyn Jacob Bornstein Hagay Amir Michael Bahar Amir Haim Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fractures Bone Reports Hip fractures Fracture liaison service Osteoporosis Rehabilitation |
| title | Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fractures |
| title_full | Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fractures |
| title_fullStr | Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fractures |
| title_full_unstemmed | Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fractures |
| title_short | Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fractures |
| title_sort | inpatient rehabilitation fracture liaison service fls improves outcomes for secondary prevention of hip fractures |
| topic | Hip fractures Fracture liaison service Osteoporosis Rehabilitation |
| url | http://www.sciencedirect.com/science/article/pii/S2352187225000464 |
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