title: A fracture prevention service reduces further fractures two years after incident minimal trauma fracture.
abstract: OBJECTIVE
  To evaluate the impact of a fracture prevention clinic service on initiation of treatment, continuing treatment and subsequent minimal trauma fractures (MTF).
  
  
  METHODS
  Participants were people aged 50 and over, with a minimal trauma fracture presenting to the Emergency Department (ED) in a large tertiary referral hospital in New South Wales, Australia, between February 2007 and March 2009. A cohort of patients who attended a Fracture Prevention Clinic (clinic group) were compared with a cohort who did not attend the clinic (non-clinic group). A telephone questionnaire was conducted with participants or their carers between December 2010 and April 2011 at least 12 months post-fracture presentation. Questionnaire items included demographics, fracture types, osteoporosis treatment, recurrent fractures and smoking and dietary habits. Data were compared using chi-squared test for categorical variables and Student's t-test or Mann-Whitney U-test for continuous variables.
  
  
  RESULTS
  Two hundred and fourteen clinic attendees and 220 non-clinic attendees were surveyed between 12 and 40 months (mean 24 months) post-initial fracture. New fracture rates were lower in the clinic group (5.1%) than the non-clinic group (16.4%, P < 0.001). Treatment rates for bone fragility were higher in the clinic group (81.3%) than in the non-clinic group (54.1%, P < 0.001) with 66.8% of the clinic group and 34.1% of the non-clinic group on a bisphosphonate or strontium ranelate at the time of the survey (P < 0.001).
  
  
  CONCLUSIONS
  Patients managed by a fracture prevention clinic service following a MTF have fewer new fractures and are more likely to be on treatment for bone fragility.
authors.affiliation: Bone and Joint Centre, Royal Newcastle Centre, Newcastle, New South Wales, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Van der Kallen
authors.forename: Michelle
authors.initials: M
authors.lastname: Giles
authors.forename: Kerry
authors.initials: K
authors.lastname: Cooper
authors.forename: Kerry
authors.initials: K
authors.lastname: Gill
authors.forename: Vicki
authors.initials: V
authors.lastname: Parker
authors.forename: Agness
authors.initials: A
authors.lastname: Tembo
authors.forename: Gabor
authors.initials: G
authors.lastname: Major
authors.forename: Linda
authors.initials: L
authors.lastname: Ross
authors.forename: Jan
authors.initials: J
authors.lastname: Carter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D004032:Diet / Q000009:adverse effects; D005247:Feeding Behavior; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D010024:Osteoporosis / Q000188:drug therapy / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D010359:Patient Readmission; D011314:Preventive Health Services; D011446:Prospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents
keywords: fracture liaison service; osteoporosis