Secondary fracture prevention needs to happen in the country too: The first two and a half years of the Coffs Fracture Prevention Clinic.

Abstract

To report the initial two and a half years' experience of one of the first Fracture Liaison Services in regional Australia. Case study. Hospital Clinic, mid-north coast NSW. Patients aged ≥50 years with a fragility fracture identified at Coffs Harbour Health Campus July 2012 to December 2014. Patients were identified by a Fracture Liaison Coordinator (FLC) and seen in Fracture Prevention Clinic (FPC) by a rheumatologist. Patients discharged from FPC were contacted via telephone on one occasion 12 months later. Number/characteristics of patients seen in or declining an appointment in FPC, type of bone protective therapy commenced and patient adherence with this. An appointment in FPC was offered to 222 patients but declined by 56 patients. One hundred and sixty-six patients were seen in FPC, of whom 40% (n = 66/166) had a prevalent fragility fracture but only 12% (n = 8/66) were on bone protective therapy. Eighty-two percent (n = 136/166) commenced bone protective therapy. Of the 55 patients discharged from FPC with long enough follow-up to allow contact at 12 months, 60% (n = 33/55) required bone health advice during the follow-up telephone call at 12 months. Of the 31 patients who commenced bone protective therapy, 65% (n = 20/31) said they were adherent with medication. A FLC, committed clinician and supportive hospital environment were all that was required for an effective Fracture Liaison Service in a regional hospital. The number of patients who declined an appointment suggested the implications of a fragility fracture were often not appreciated.