title: Evaluation of the first fracture liaison service in the Greek healthcare setting.
abstract: We evaluated the first implementation of FLS in the Greek healthcare setting, at the 251 Hellenic Air Force and VA General Hospital of Athens. Participation rate was moderate (54.5%) and needs improvement; osteoporosis medication was either suggested or reviewed in 74 out of the 116 patients recruited.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the first implementation of a fracture liaison service (FLS) in Greece, at the 251 Hellenic Air Force and VA General Hospital, Athens.
  
  
  METHODS
  Single-center, prospective study from May 1, 2013 to April 30, 2015 (first year-second year follow-up) was conducted. Patients of both genders aged 40-90 years old, with a history of a low trauma fracture and willing to participate, were included after identification by an FLS nurse. Following recruitment, osteoporosis risk factors were assessed, FRAX score was calculated for treatment-naïve patients, bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry (DXA), and osteoporosis treatment was suggested where applicable. The rate of participation, the indication of osteoporosis treatment, and the difficulties met were evaluated.
  
  
  RESULTS
  Of the eligible 213 patients, 97 (45.5%) were reluctant to participate for personal reasons. From the 116 initially recruited patients (mean age 74.8 ± 12 years), 77 (66.4%) discontinued their participation at some point for various reasons and 39 patients concluded the study. All 116 patients were assessed for osteoporosis risk factors and given a tailor-made exercise and education program, while FRAX score was assessed in all treatment-naïve patients (74 patients, 63.8%). Osteoporosis medication was suggested or reviewed in 74 patients; however, an adherence rate of 100% is only available for the 24 who concluded the study.
  
  
  CONCLUSIONS
  We report the first implementation of FLS in the Greek healthcare setting. The participation rate is moderate and definitely needs improvement.
authors.affiliation: Department of Endocrinology and Diabetes, 251 Hellenic Air Force General Hospital, 3 Kanellopoulou st, 115 25, Athens, Greece. pmakras@gmail.com.
authors.forename: Polyzois
authors.initials: P
authors.lastname: Makras
authors.affiliation: Nursing Sector, 251 Hellenic Air Force General Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Panagoulia
authors.affiliation: 2nd Department of Internal Medicine, 251 Hellenic Air Force General Hospital, Athens, Greece.
authors.forename: Andriana
authors.initials: A
authors.lastname: Mari
authors.affiliation: Hellenic Osteoporosis Foundation, Athens, Greece.
authors.forename: Stavroula
authors.initials: S
authors.lastname: Rizou
authors.affiliation: Hellenic Osteoporosis Foundation, Athens, Greece.
authors.forename: George P
authors.initials: GP
authors.lastname: Lyritis
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000145:classification / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000379:methods / Q000458:organization & administration; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D050071:Bone Density Conservation Agents
keywords: Fracture; Fracture liaison service; Greece; Osteoporosis