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- Title
Application of an in-hospital, surgeon-led anti-osteoporotic medication algorithm in patients with hip fractures improves persistence to medication and can prevent the second fragility fracture.
- Authors
Daskalakis, Ioannis I.; Kritsotakis, Evangelos I.; Karantanas, Apostolos H.; Kontakis, Georgios M.; Bastian, Johannes D.; Tosounidis, Theodoros H.
- Abstract
Introduction: Secondary fracture prevention is an essential part of hip fracture treatment. Despite this, many patients are discharged without the appropriate anti-osteoporotic medication. The aim of this study is to report the outcomes of the application of an in-hospital, surgeon-led anti-osteoporotic medication algorithm to patients with hip fractures. Materials and methods: This prospective cohort study followed patients with hip fractures who were treated at a tertiary referral hospital between 2020 and 2022. At discharge, anti-osteoporotic medication according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) Foundation algorithm was prescribed to all patients. Multivariate Cox regression analysis was used to investigate the risks of non-persistence to medication and of secondary fracture. Results: Two hundred thirteen consecutive patients were prospectively followed. Mean follow-up was 17.2 ± 7.1 months. Persistence to medication at 2 years was 58% (95%CI 51–65%). A secondary osteoporotic fracture occurred in 1/126 (0.8%) persistent patients and 9/87 (11.4%) non-persistent patients. Multivariable Cox regression analysis confirmed that persistence to medication was significantly associated with a lower risk of secondary fracture (cause-specific hazard ratio [csHR] 0.05; 95%CI 0.01–0.45; p = 0.007). Conclusion: The application of the surgeon-led AO Foundation algorithm enables the in-hospital initiation of anti-osteoporotic treatment, leading to better persistence to medication and decreased incidence of secondary osteoporotic fractures.
- Subjects
HIP fractures; BONE fractures; DRUGS; TREATMENT of fractures; ALGORITHMS; HOSPITAL admission &; discharge
- Publication
Archives of Orthopaedic & Trauma Surgery, 2024, Vol 144, Issue 2, p683
- ISSN
0936-8051
- Publication type
Article
- DOI
10.1007/s00402-023-05132-1