Abstract

Summary

Significant dropout rates have been observed throughout Fracture Liaison Service (FLS) programs, especially for elderly patients. In an FLS program set up specifically for patients over 70, the non-initiation of osteoporosis treatment was the only factor associated with poor adherence to the program. Neither age nor frailty factors affected adherence.

Introduction

FLS programs are considered the most effective interventions for secondary prevention of osteoporotic fractures. Our objective was to identify risk factors for non-adherence to an FLS program set up specifically for patients over 70.

Methods

Our multifaceted, intensive program included five appointments over a 2-year period. One hundred sixty-seven patients (mean age 83.5 years) who presented with a recent fragility fracture were enrolled. Multivariable analysis was conducted to determine whether the demographic, clinical, frailty, and osteoporotic risk factors of the patients influenced their adherence to the program.

Results

About half of the patients did not attend the follow-up visits. According to the regression analysis, non-initiation of osteoporosis treatment was associated with poor adherence to the program (aHR 3.66). Demographic, clinical, dwelling, frailty factors, osteoporotic risk factors, fracture type, or densitometric scores were not associated with adherence. The first self-reported reason for withdrawal was the difficulty of attending several follow-up visits, and the second was the feeling of not being concerned.

Conclusion

We observed that non-initiation of osteoporosis treatment was the only factor correlated with non-adherence to an FLS program. Thus, neither age nor frailty factors should result in patients not being included in FLS. Beyond the necessity of the osteoporosis treatment, good patient understanding of the relevance of all the interventions included in the program is the key.

中文翻译：

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遵守70岁以上患者的骨折联络服务计划：冰山的隐藏部分

摘要

概要

在整个骨折联络服务（FLS）计划中都观察到明显的辍学率，尤其是对于老年患者。在专门针对70岁以上患者建立的FLS程序中，未开始进行骨质疏松治疗是与该程序依从性差相关的唯一因素。年龄和脆弱因素都不会影响依从性。

介绍

FLS计划被认为是二级预防骨质疏松性骨折的最有效干预措施。我们的目标是确定不遵守专门为70岁以上患者设立的FLS计划的风险因素。

方法

我们的多层面密集计划包括在2年期间内的五项任命。167例患者（平均年龄83.5岁）最近出现了脆性骨折。进行多变量分析以确定患者的人口统计学，临床，虚弱和骨质疏松危险因素是否影响他们对该计划的依从性。

结果

大约一半的患者没有参加随访。根据回归分析，骨质疏松症治疗未开始与依从性差有关（aHR 3.66）。人口统计学，临床，居住，脆弱因素，骨质疏松危险因素，骨折类型或光密度法评分与依从性无关。自我报告退出的第一个原因是难以参加几次随访，第二个原因是没有受到关注的感觉。

结论

我们观察到骨质疏松症治疗未开始是与未坚持FLS计划相关的唯一因素。因此，年龄和脆弱因素都不应导致患者不被纳入FLS。除了必须进行骨质疏松治疗之外，关键是要让患者对程序中包括的所有干预措施的相关性有很好的了解。