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Background Adherence to treatment in osteoporosis (OP) is not adequate, so that in the first year the percentage of suspensions is between 30% and 50%, up to an adherence of 20% at 3 years. In 2012, we started in Gran Canaria a Fracture Liaison Service (FLS). Objectives To describe the factors associated to an effective initiation of treatment after the baseline visit to our FLS. Methods Prospective observational study that consists of: 1) training of primary care physicians (GP), 2) capture of patients; 3) baseline visit: questionnaire including FRAX; 4) Bone densitometry; 5) patient education by a Nurse with special attention to adherence; 6) referral to GP with a report with management recommendations; those with multiple fractures or who require parenteral therapy were referred to rheumatology; and 7) follow-up by telephone survey to check whether the treatment was taking and confirmation of the prescription in the electronic records (both of which are necessary to consider an effective start of treatment). The variables included were: sex, age, type of fracture, use of previous bisphosphonate, type of prescribed treatment, prescribing physician and causes of non-adherence. Results Up to December 2017, the adherence of 887 patients with fragility fractures to whom a bisphosphonate or equivalent was prescribed, was recorded. Treatment was initiated in the following 3 months by 74% (n=656) of patients. The following variables were associated with the initiation of treatment: female sex, previous treatment with antiresorptives, prescription of denosumab vs bisphosphonate and treatment precribed by a rheumatologist vs GP (table 1). The causes of not initiating or withdrawing the treatment at 3 months are shown in table 2. In the regression analysis, we found a significant association with the effective initiation of treatment with a pevious treatment with bisphosphonate (p Conclusions 74% of patients seen in the FLS start treatment within 3 months of the baseline visit. The factors associated with the initiation of therapy were prior antiresorptive treatment, denosumab prescription and initial prescription by the rheumatologist. The reason of non adherence in half of the cases is the GP’s refusal to initiate or continue the FLS recommendation. Disclosure of Interest None declared |
