Worldwide, a care gap has been recognized between presenting with a fragility fracture and prevention of the next fracture. Fracture Liaison Service is the most cost-effective method to close this gap, but its implementation is sparse in many countries. To assess the need for a subsequent fracture prevention program in Denmark, we conducted a cross-sectional study named OFELIA - aiming to estimate the prevalence of osteoporosis in a Danish cohort of fragility fracture patients aged 18+ years. Over at 12 month period, patients were consecutively identified when treated for fragility fractures at Aarhus University Hospital. Patients were informed about bone health and asked to participate in the study meaning accepting a DXA and answering questions about risk factors. Of 1164 identified patients, 832 were included and 794 (70% women, 66% aged ≥50 years) patients completed the investigation. The overall prevalence of osteoporosis in this cohort according to WHOs criteria of a T-score at hip or spine below −2.5 was 14.9% (118 patients, of these 20 patients knew their diagnose on forehand), increasing to 20.3% in patients ≥50 years (22.9% in women, 9.6% in men). In addition to age above 50 years, female sex, low BMI, and early menopause were significantly associated with osteoporosis. At 3-years follow-up we performed interviews in 93 out of 98 patients diagnosed with osteoporosis according to OFELIA. Of these, a total of 75 patients (81%) received anti-osteoporosis treatment initiated by their GP as a result of the DXA result and 71 (95%) were still after three years - adherent to treatment. In the group of 93 interviewed patients ten had experienced a subsequent (minor) fracture and 84 patients supplied their daily intake of calcium and D-vitamin. Control DXA after 23 years performed in 56 patients showed increasing bone mineral density in 49 (87.5%) patients. Given that osteoporosis was demonstrated in one of five patients aged 50 years or older treated for a fracture at AUH, OFELIA stresses the need for implementation of a program aiming to secure appropriate investigation and treatment in patients presenting a fragility fracture. A suggested high adherence to initiated treatment in patients diagnosed with osteoporosis after a fracture indicates a beneficial outcome of FLS.
18 - 21 May 2019
European Society of Endocrinology