Factors Associated With Nonattendance for Osteoporosis Evaluation Following Fragility Fracture

Area of Science:

• Gerontology
• Orthopedics
• Public Health

Background:

• Osteoporosis evaluation is crucial after fragility fractures to prevent future bone breaks.
• Fracture Liaison Services (FLS) aim to improve osteoporosis care coordination.
• Identifying barriers to post-fracture osteoporosis evaluation is essential for optimizing patient outcomes.

Purpose of the Study:

• To determine demographic factors associated with nonattendance for osteoporosis evaluation following referral to a Bone Health Clinic (BHC).
• To analyze attendance rates for osteoporosis evaluation after fragility fractures.

Main Methods:

• Retrospective chart review of 507 patients referred to a hospital-based BHC (FLS) over 39 months.
• Data collected included patient demographics, fracture type, and osteoporosis evaluation attendance.
• Nonattendance was defined as no recorded evaluation within one year of the fracture date.

Main Results:

• Only 177 out of 507 referred patients attended osteoporosis evaluation.
• Nonattendance was significantly associated with older age (p=0.0075), private insurance (p=0.0434), and hip fractures (p < 0.0001).
• Attendance was associated with government health insurance (p=0.0103).

Conclusions:

• Older patients and those with hip fractures represent a vulnerable population with higher rates of nonattendance for osteoporosis evaluation.
• Inpatient osteoporosis assessment and treatment should be considered for these high-risk individuals.
• Targeted interventions may be needed to improve post-fracture osteoporosis care access and adherence.