No Más Fracturas - Implementación de la primera Unidad de Coordinación de Fracturas en Chile: experiencia al año de funcionamiento

Resumen

Background: Every year about 9 million fragility fractures (FF) occur worldwide and 80% of these are underdiagnosed or undertreated. Aiming to close the gap of diagnosis and treatment of osteoporosis, Fracture Liaison Services (FLS) were developed. Aim: To describe the implementation of the first FLS in Chile, its inclusion criteria, patient enrolment, treatment adherence and referrals during the first year. Material and methods: A FLS was implemented at a health care network composed by two hospitals. The International Osteoporosis Foundation (IOF) guidelines were applied with a nurse practitioner as the coordinator. From May 2020 to April 2021 all patients diagnosed with a FF in the emergency rooms were invited to participate. Patients with pathological fractures and active cancer were excluded. Demographical data, fracture location, previous fractures, treatment and adherence, and mortality were recorded. Results: From 443 patients with a diagnosis of FF, 177 patients (40%) accepted to participate. Their mean age was 74±13 years and 84% (149) were female. Forty eight percent (84) had a lower extremity FF. Hip fractures were the most common (67). Ninety-five patients reported previous FF and 11.2% (20) had received anti-osteoporotic treatment. At four months of follow-up, 62% (50) had received vitamin D and calcium supplementation and 20% (16) of those patients with an indication of anti-osteoporotic drugs, had received them. Conclusions: The implementation of the FLS was successful with a 40% enrolment of patients, receiving certification by the IOF.