The following is a summary of “Inpatient Zoledronic Acid and Integrated Orthopedic and Fracture Liaison Services Improve Osteoporosis Treatment Rates,” published in the January 2023 issue of Endocrinology & Metabolism by Fan, et al.

Risks for further fractures, morbidity, and mortality rise with fragility fractures. Although safe and effective, available pharmaceutical treatment for underlying osteoporosis is rarely used. For a study, researchers sought to raise the secondary osteoporotic fracture prevention rate with medication.

Patients admitted to the Massachusetts General Hospital with fragility fractures between February 2016 and December 2019 were included in the single-center, observational, follow-up study. The Fracture Liaison Service (FLS) at Massachusetts General Hospital was routinely consulted for patients admitted to the orthopedics service with fragility fractures. The first FLS outpatient follow-up appointment was set up in combination with the orthopedic postoperative check-up. During the index fracture hospitalization, zoledronic acid (ZA) was given to patients at risk of not receiving timely outpatient follow-up. The primary outcome measures included the percentage of patients with fragility fractures who began taking medication for osteoporosis, the typical length of stay, and the 30-day readmission rate for patients who received ZA.

The incorporation of FLS into the orthopedics service, together with adequate inpatient ZA administration, boosted the pharmacotherapy rate among qualified patients with verified treatment status to 70% (412/589) as compared to baseline (8-11%) & reference (5-20%) rates. Neither the 30-day readmission rate nor the average length of stay was impacted by inpatient ZA administration. However, due to incomplete or illegitimate follow-up, the treatment status of 37.9% (471/1240) of the trial participants needed to be clarified.

When FLS and orthopedics treatments were combined with inpatient ZA administration, the osteoporosis pharmacotherapy rate among patients with fragility fractures—who frequently faced challenges with outpatient follow-up—improved.