Application of fracture liaison service model in patients with osteoporotic vertebral compression fractures / 中华创伤杂志

ABSTRACT

Objective To investigate the effects of fracture liaison service(FLS)model on the medication compliance of patients,quality of life,pain and re-fracture rate in patients with osteoporotic vertebral compression fracture(OVCF).Methods A prospective case control study was conducted to analyze the clinical data of 117 OVCF patients admitted to Department of Pain of Guizhou Provincial People's Hospital from January 2017 to September 2017.According to the random table method,patients were divided into control group(58 patients)and intervention group(59 patients).Routine nursing was adopted in the control group,and fracture liaison service mode was adopted in the intervention group on the basis of the control group until 3 months after discharge.Morisky scale was used to compare the medication compliance of patients on admission,at discharge,1 month,and 3 months after discharge,and SF-36 was used to evaluate the quality of life.The SF-36 scale contained eight dimensions including physiological function,physiological performance,physical pain,overall health,varsity,social function,emotional function and mental health.Visual analogue scale(VAS)was used to evaluate the pain of patients.The re fracture rates of the two groups were compared.Results There were no significant differences between the two groups concerning gender,age,history of diabetes,history of hormone use,number of vertebral fractures,fracture site and cause of injury(P＞0.05).In the intervention group,the medication compliance scores of patients in the first and third months after discharge were(5.5±2.0)points and(6.3±1.8)points,which were higher than those in the control group [(3.5 ±2.2)points and(3.3± 1.8)points](P＜0.05).Within each group,there were significant differences among the medication compliance scores at the different time points of evaluation(on admission,at discharge,1 month,and 3 months after discharge).The scores of the eight dimensions of the SF-36 scale in the intervention group were higher than those in the control group at 1 st and 3rd months after discharge(P＜0.05).Within each group,there were significant differences among the SF-36 scores at the different time points of evaluation.The pain scores of the intervention group at discharge and 1st and 3rd months after discharge were(3.1±1.7)points,(1.8±1.3)points,(1.4±1.3)points,all lower than those in the control group [(5.2±1.7)points,(3.6±1.6)points,(2.7±1.8)points](P＜0.05).Within each group,there were significant differences among the pain scores at the different time points of evaluation.At 1 st and 3rd months after discharge,the re-fracture rates of the intervention group were both 2％,and the those of the control group were 3％and 9％,respectively,showing no significant difference between the two groups(P＞0.05).Conclusion The FI.S model can effectively alleviate the pain of OVCF patients,improve the medication compliance and quality of life of patients after discharge,but it cannot reduce the short-term re fracture rate after discharge.