Adherence to secondary fracture prevention is associated with reduced risk of subsequent fractures.
| Title: | Adherence to secondary fracture prevention is associated with reduced risk of subsequent fractures. |
|---|---|
| Authors: | Bjørnerem Å; Department of Clinical Medicine, UiT - The Arctic University of Norway, N-9037, Tromsø, Norway. ashild.bjornerem@uit.no.; Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway. ashild.bjornerem@uit.no.; Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway. ashild.bjornerem@uit.no.; Khoshkhabari J; Department of Clinical Medicine, UiT - The Arctic University of Norway, N-9037, Tromsø, Norway.; Hansen AK; Department of Clinical Medicine, UiT - The Arctic University of Norway, N-9037, Tromsø, Norway.; Department of Orthopedic Surgery, University Hospital of North Norway, Tromsø, Norway.; Borgen TT; Department of Rheumatology, Vestre Viken Hospital Trust, Drammen Hospital, Drammen, Norway.; Frihagen F; Department of Orthopaedic Surgery, Østfold Hospital Trust, N-1712, Grålum, Norway.; Institute of Clinical Medicine, University of Oslo, N-0407, Oslo, Norway.; Solberg LB; Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.; Omsland TK; Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.; Nissen FI; Department of Clinical Medicine, UiT - The Arctic University of Norway, N-9037, Tromsø, Norway.; Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway.; Department of Orthopedic Surgery, University Hospital of North Norway, Tromsø, Norway. |
| Source: | Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [Osteoporos Int] 2025 Nov; Vol. 36 (11), pp. 2263-2272. Date of Electronic Publication: 2025 Sep 24. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Springer International Country of Publication: England NLM ID: 9100105 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-2965 (Electronic) Linking ISSN: 0937941X NLM ISO Abbreviation: Osteoporos Int Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London, UK : Springer International, c1990- |
| MeSH Terms: | Osteoporotic Fractures*/prevention & control ; Osteoporotic Fractures*/mortality ; Osteoporotic Fractures*/epidemiology ; Secondary Prevention*/methods ; Bone Density Conservation Agents*/therapeutic use ; Bone Density Conservation Agents*/administration & dosage; Norway/epidemiology ; Risk Assessment/methods ; Osteoporosis/drug therapy ; Humans ; Female ; Male ; Middle Aged ; Aged ; Aged, 80 and over |
| Abstract: | Attenders to fracture liaison services in a quality assessment study of 1936 women and men ≥ 50 years had 20% lower risk of subsequent fractures and 33% lower mortality than non-attenders. Patient's who were adherent to AOD after 12 months had a 49% lower risk of fractures than non-adherent patients.; Purpose: Secondary fracture prevention rates are low in Norway and internationally. To overcome the existing treatment gap, fracture liaison services (FLS) are recommended. The study aimed to assess impact of FLS on fracture rates and mortality among attenders versus non-attenders, and patients adherent versus non-adherent to AOD.; Methods: This single-center sub-study of the Norwegian Capture the Fracture Initiative included 1936 women and men ≥ 50 years of age with an index fracture of any type during 2015-2018. We estimated hazard ratios (HR) for subsequent fractures and mortality in 1041 attenders versus 895 non-attenders to the FLS, and 427 patients who were adherent versus 174 patients who were non-adherent to anti-osteoporotic drugs (AOD) 12 months after treatment initiation.; Results: During a median 3.5-years observation (range 0.5 to 6.3), attenders had a 20% lower risk of subsequent fractures of any type (HR 0.80; 95% CI 0.64-0.999) and 33% lower mortality (HR 0.67; 95% CI 0.51-0.89) than non-attenders. Patients who were adherent to AOD after 12 months had a 49% lower risk of subsequent fractures than non-adherent patients (HR 0.51; 95% CI 0.35-0.72), but no difference in mortality was shown. Models were adjusted for age, sex, body mass index, smoking, prior fracture, and index hip fracture.; Conclusion: These results confirm that patients who were able and willing to attend FLS had lower risk of subsequent fractures and mortality than non-attenders. Patients who were adherent to AOD had lower risk of subsequent fractures than non-adherent patients, emphasizing the importance of adherence in secondary fracture prevention.; (© 2025. The Author(s).) |
| Competing Interests: | Declarations. Conflict of interest: ÅB, JK, AKH, TKO and FIN, no support from any organization for the submitted work; FF reports lecturing fees from UCB and Amgen; TTB reports speaker fees from UCB, Amgen, Roche Diagnostics, and Pharma Prim and participation in an advisory board for UCB, LBS reports speaker fees from Eli Lilly, Amgen and UCB. |
| References: | Osteoporos Int. 2014 Oct;25(10):2359-81. (PMID: 25182228); Bone. 2014 Jun;63:81-6. (PMID: 24607943); Arch Intern Med. 2004 May 24;164(10):1108-12. (PMID: 15159268); Age Ageing. 2016 Mar;45(2):236-42. (PMID: 26802076); Osteoporos Int. 2025 Mar;36(3):501-512. (PMID: 39808195); Osteoporos Int. 2016 Mar;27(3):873-879. (PMID: 26650377); Osteoporos Int. 2018 May;29(5):1023-1047. (PMID: 29525971); Osteoporos Int. 2019 Jan;30(1):3-44. (PMID: 30324412); JAMA Netw Open. 2018 Dec 7;1(8):e185701. (PMID: 30646281); Osteoporos Int. 2011 Jan;22(1):21-6. (PMID: 20458571); J Bone Joint Surg Am. 2014 Feb 19;96(4):e29. (PMID: 24553898); Eur J Epidemiol. 2009;24(8):441-8. (PMID: 19484362); Bone. 2017 Dec;105:11-17. (PMID: 28789921); Osteoporos Int. 2024 Jul;35(7):1195-1204. (PMID: 38573517); Arch Osteoporos. 2015;10:235. (PMID: 26334427); Bone. 2018 Nov;116:58-66. (PMID: 30021126); Eur J Epidemiol. 2012 Oct;27(10):807-14. (PMID: 22870851); N Engl J Med. 2020 Aug 20;383(8):743-753. (PMID: 32813950); Osteoporos Int. 2024 Aug;35(8):1337-1358. (PMID: 38587674); Osteoporos Int. 2016 Nov;27(11):3165-3175. (PMID: 27230521); Ther Adv Musculoskelet Dis. 2017 Jul;9(7):157-164. (PMID: 28717402); Osteoporos Int. 2019 Nov;30(11):2155-2165. (PMID: 31388696); Curr Opin Rheumatol. 2017 Jul;29(4):416-421. (PMID: 28426444); Osteoporos Int. 2021 Aug;32(8):1517-1530. (PMID: 33829285); J Bone Miner Res. 2020 Jul;35(7):1216-1223. (PMID: 32097504); J Clin Med. 2022 Dec 20;12(1):. (PMID: 36614816); N Engl J Med. 2007 Nov 1;357(18):1799-809. (PMID: 17878149); Calcif Tissue Int. 2016 Mar;98(3):235-43. (PMID: 26746477); PLoS One. 2018 Jun 1;13(6):e0198006. (PMID: 29856795); Osteoporos Int. 2013 Apr;24(4):1225-33. (PMID: 22776863) |
| Contributed Indexing: | Keywords: Fracture liaison services; Men; Mortality; Secondary fracture prevention; Subsequent fracture; Women |
| Substance Nomenclature: | 0 (Bone Density Conservation Agents) |
| Entry Date(s): | Date Created: 20250924 Date Completed: 20251117 Latest Revision: 20251121 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12628403 |
| DOI: | 10.1007/s00198-025-07697-6 |
| PMID: | 40993438 |
| Database: | MEDLINE |
Journal Article