Secondary fracture risk fell by 18% when high-risk elders received coordinated fracture care, say Swedish researchers. 

Investigators studied outcomes in Swedish hospitals that had introduced fracture liaison services. In this model, a care coordinator identifies fracture patients and determines their fracture risk to help manage effective osteoporosis treatment.

Nordic elders are known to be particularly prone to osteoporosis and fracture. After age 50, lifetime fragility fracture risk in this group is 50% among women and 25% among men. In the study, more than 21,000 participants were evaluated after a first fracture of the hip, vertebra, upper arm, wrist or pelvis. Investigators compared secondary fracture risk in these patients to outcomes in patients without access to fracture care coordination.

Recurrent fracture risk levels fell when fracture liaison services were introduced, though falls injury risk was unchanged, the researchers found. This suggests that the risk reduction is tied to an increase in osteoporosis drug prescriptions provided to the fracture liaison group, said professor Kristian Axelsson, from the University of Gothenburg. Among participants older than 82, only 16 required screening in order to prevent a new fracture in 5 years, he said.

Meanwhile, there was no increase in osteoporosis medication prescriptions and no reduction in new fracture risk in hospitals that did not introduce a fracture liaison program, investigators found.

“The results show that simple changes in our care routines have the intended effect, with fewer fractures as a result,” concluded Mattias Lorentzon, professor of geriatrics.

Individuals have four to five times greater odds of subsequent fractures in two years after the first event, compared with those who have had no fracture. After two years, the risk is twice as high, the researchers said. 

The study was published in the Journal of Bone and Mineral Research.