Management of Osteoporosis in Fracture Liaison Service Associated with Long-term Adherence to Treatment

Summary: Adherence to osteoporosis treatment is not satisfactory. Our study evaluated persistence and compliance with these treatments prescribed specifically in the context of a fracture liaison service (FLS), an internal health care network, and showed that this type of organization in our institution was associated with high level of adherence.

Introduction: Medical management of patients with a fragility fracture has been improved by health care internal network or FLS organized in large hospitals. However, treatment effectiveness is not only related to larger initiation rate but also to better long-term adherence. Therefore, we evaluated persistence and compliance in the context of osteoporosis treatment initiated in our institution's FLS, among postmenopausal women with a peripheral fragility fracture.

Methods: Patients with a specific osteoporosis treatment prescribed while visiting our FLS were contacted by phone to answer an evaluation questionnaire. A simplified questionnaire was sent to their general physicians when we were not able to reach patients on the phone.

Results: Of the 279 selected patients, 155 were evaluated. Of them, 90.3% had actually started their treatment and 80% were still under treatment after 1 year. After 27.4 ± 11.7 months of follow-up, 67.7% of patients were persistent with their treatment. In addition, 87% of the persistent patients declared to respect both treatment posology and administration conditions. Occurrence of adverse events was the first cause of treatment interruption within the first 6 months.

Conclusions: Our data showed a high level of persistence with osteoporosis treatment when initiation was performed in an FLS, even on a long-term basis. Since follow-up and renewal of treatment were under routine daily practise, our study underlines how important the first prescription conditions are and provides additional interest in medical care network such as FLS.