OP0103 Fracture Liaison Service Implemented in A Metropolitan Tertiary Centre in Western Australia Improved Treatment and Recurrent Fracture Rates by 12 Months
Authors: C.A. Inderjeeth, W. Raymond, E. Geelhoed, A. Briggs, K. Briffa, D. Oldham, J. McQuade, D. Mountain
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Osteoporotic fractures impose a significant morbidity, mortality and economic burden (1). Research within our hospital confirmed low rates of identification and secondary prevention for patients discharged from Emergency Department (ED) with a fracture (2). The Fracture Liaison Service (FLS) aimed to identify, review and then manage these patients following their discharge from the ED. <h3>Objectives</h3> To evaluate the performance of a FLS in a Western Australian hospital. <h3>Methods</h3> Patients aged &gt;50 yrs who presented to the Emergency Department after a fracture at Sir Charles Gairdner Hospital (SCGH) were invited to the FLS. A retrospective control group from SCGH determined the historical fracture risk without an active FLS intervention. Fremantle Hospital was used as a prospective control cohort. Demographic data was collected at baseline then patients were followed up at 3 &amp; 12 months. The follow-up survey collected information on: awareness of osteoporosis, investigations undertaken (e.g. BMD testing), had a diagnosis been made, medication usage, health care utilisation, falls &amp; fracture information and quality of life (EQ-5D). <h3>Results</h3> The FLS reduced the recurrence of minimal trauma fractures over 12 months by between 9.2 to 10.2% compared to a retrospective cohort &amp; a prospective control cohort. 167 or 69.3% of eligible patients agreed to attend the Fragile Bone Clinic. As the program becomes more main-stream the utilisation of the service is expected to increase. The FLS demonstrated a 17.1% increase in patient <i>awareness of osteoporosis</i> compared to other sites and by 35.6% compared to the SCGH retrospective group over 12 months (p&lt;0.001). The FLS had better prescription rates of calcium (57.4% vs 28.8%), vitamin D (59.8% vs 33.0%), optimised calcium &amp; vitamin D (48.4% vs 19.8%) and anti-resorptive therapy (29.9% vs 16.2%) compared to the retrospective cohort at SCGH. At 12 months the FLS had the highest number (n=82) and rate (46.9%) of patients initiated on pharmacological treatment compared to other sites 17 (41.5%) and SCGH Retrospective 12 (16.0%). The FLS incrementally improved the prescription, adherence and compliance with of osteoporosis treatment. <h3>Conclusions</h3> By 12 months the Fracture Liaison Service demonstrated that it reduced the recurrent fracture rate and significantly improved rates of pharmacological treatment initiation &amp; patient awareness of osteoporosis. <h3>References</h3> Briggs AM et al. (2015) Hospitalisations, admission costs and re-fracture risk related to osteoporosis in Western Australia are substantial: a 10-year review. ANZ J Public Health. Inderjeeth CA et al. (2010) A multimodal intervention to improve fragility fracture management in patients presenting to Emergency Departments. MJA <h3>Disclosure of Interest</h3> None declared