"Fracture liaison" duty service at the clinic Klagenfurt Wörthersee - Initial results of an interdisciplinary project

Introduction: After surgical stabilization of osteoporosis-related fractures, patients often do not receive any osteoporosis medication for fracture risk reduction according to current guidelines. Aims: This well-known problem should be reduced through interdisciplinary projects. Patients who have faced an osteoporosis-related fracture should be managed bedside at the surgical departments in order to add drug therapies for osteoporosis to the surgical management and, if necessary, order additional diagnostic measures. Results: During a pilot project that lasted for 3 months, a total number of 77 patients (63 women, 14 men) were admitted to this fracture liaison duty service. Five patients denied any special medical consultation. Although the majority of the 72 patients revealed a significantly increased fracture risk based on FRAX analysis, only some of them already had an established osteoporosis therapy (vitamin D 29.2 %, calcium 26.4 %, specific osteoporosis medication 19.4 %). In 66 of 72 consulted patients an osteological recommendation could be given, in 7 of these cases under the condition that an additional osteodensitometry will be performed. The given recommendations tried to include the specific clinical conditions of the patients into the decision making, thus all currently available therapeutic options of osteoporosis therapy were subscribed. In 5 patients no evidence of osteoporosis was present and in only one patient a decision could not be made due to the lack of adequate clinical information. Conclusion: The fracture liaison duty bedside at the surgical departments improved patient care according to current consensus statements mainly in terms of a more interdisciplinary management which then also included differentiated advice for long-term osteoporosis medication for further fracture risk reduction. Standardization and further improvements of algorithms in the diagnostic and therapeutic workup of patients with osteoporosis after falls will most likely further improve range and effectiveness of such interdisciplinary patient managements, which might be the topic for further projects