An evaluation of an enhanced fracture liaison service as the optimal model for secondary prevention of osteoporosis

OBJECTIVE To assess secondary preventative therapy among postmenopausal female inpatients (aged 75 years and over) receiving surgical management for a fractured neck of femur using two service delivery models. DESIGN Practice in two fracture units was audited and compared using the NICE guidelines (TA 87) as an audit standard. SETTING TWO FRACTURE UNITS: one with a fracture liaison service and one without. PARTICIPANTS Postmenopausal female inpatients (aged 75 years and over) receiving surgical management for a fractured neck of femur. MAIN OUTCOME MEASURES Rate of anti-resorptive treatment and rate of enquiry into risk factors. RESULTS There was a significantly higher rate of anti-resorptive treatment (90.5% compared to 60.9% with a difference of 29.6%, p < 0.001) and enquiry into risk factors (83% compared to 7%) in the unit with a fracture liaison service. CONCLUSIONS We propose that a hospital-based enhanced fracture liaison service may result in higher osteoporosis treatment rates among postmenopausal hospitalized hip fracture patients aged 75 years and over.