Are patients receiving recommended bone protection therapy after a non-hip fracture? A retrospective study of the Fracture Liaison Service at Counties Manukau District Health Board.

Abstract

To review the Fracture Liaison Service (FLS) recommendations for bone protection therapy and assess treatment implementation in the community. All patients screened from 1 January to 31 March 2019 at Counties Manukau District Health Board were evaluated. Exclusion criteria included death within six months following sentinel fracture, and hip fractures, which are studied elsewhere. Patient risk factors assessed included age, gender, type of fracture, history of previous fracture, and dual X-ray absorptiometry scan results if performed. If bone protection therapy was recommended, electronic dispensing records were utilised as a proxy for treatment initiation. One hundred and sixty-nine of the 238 patients referred were included. Thirty-seven patients had evidence of a previous fragility fracture, with thirteen patients not on bone protection treatment following their prior fracture. Of the 99 patients in the study recommended bone protection therapy, 31.3% (n=31) did not have this dispensed at six months following written FLS assessment. Three of thirteen patients with a previous fragility fracture and not on bone protection treatment, still did not have this dispensed at 6 months. A high proportion of patients recommended bone protection therapy did not receive this in a timely manner, including patients with a history of repeated fracture.