Prescribing outcomes following discharge from an osteoporosis specialist-led, post-fracture clinic: a prospective cohort study in Ontario, Canada.

Abstract

We studied the effectiveness of an osteoporosis specialist-led post-fracture clinic on treatment and persistence with anti-osteoporosis medications in real-world patients. We found that 90% of study participants filled medications as prescribed, and 89% remained persistent with therapy. Our collaborative fracture model might be useful to other fracture centers.

Purpose: Fracture liaison services (FLS) promote timely identification and treatment of osteoporosis following fragility fracture. Whether patients adhere to treatment recommendations following discharge is uncertain.

Methods: We conducted a prospective cohort study of patients aged 50 and older with an upper extremity fragility fracture seen in the Post-Fracture Osteoporosis Clinic (PFOC) at St. Joseph's Health Care London between November 2018 and March 2024. As primary outcomes, we captured the percentage of patients discharged, who filled their prescribed anti-osteoporosis medication within 6-9 months, and the percentage who filled and were subsequently re-prescribed the therapy by their primary care provider (PCP) (i.e., defined as persistent). As a secondary outcome, we examined patient characteristics associated with non-persistence.

Results: We included 201 participants in our cohort, of whom 101 (50.2%) had complete follow-up at the time of this study. Most were women (92.1%), and they had a mean age of 71.1 years. In those with complete follow-up information, 90.1% reported filling their anti-osteoporosis medication, and 89% remained persistent.

Conclusions: Our tertiary care PFOC had good success getting high-risk patients with upper arm fracture treated for osteoporosis. Over the short term, there was excellent self-reported persistence. Longer term prescription patterns, persistence, and rates of re-fracture remain important.