{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T20:50:26Z","timestamp":1792356626199,"version":"4.4.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,4,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We are not aware of any previous investigation assessing a national cohort of patients enrolled in a fracture liaison service (FLS) program in an open health-care system to ascertain prevalent practice patterns. The objective of this investigation was to determine, in a geographically diverse group of centers in a single FLS program, the percentage of patients for whom anti-osteoporosis treatment was recommended or started as well as to identify associations between patient and fracture variables and the likelihood of treatment being recommended.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The study utilized the Own the Bone program registry, which included 32,671 unique patient records with the required data. The primary outcome measure was whether a recommendation to start anti-osteoporosis treatment was made to the patient at the time of program enrollment. The associations between patient and fracture variables and the likelihood of having treatment recommended were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Anti-osteoporosis treatment was recommended to 72.8% of patients and was initiated for 12.1%. A sedentary lifestyle and a parent who had sustained a hip fracture increased the likelihood of a treatment recommendation by 10% and 12%, respectively. While patients with a spinal fracture were 11% more likely to have received a treatment recommendation, those with a hip fracture were 2% less likely to have received such a recommendation. Age was not strongly associated with the likelihood of receiving a treatment recommendation but was associated with the initiation of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Practitioners at sites in the Own the Bone program recommend anti-osteoporosis treatment, at the time of initial evaluation, to about three-quarters of patients who present with a fragility fracture. This is a very strong improvement over previously reported national data. The findings that a hip fracture had the lowest association and age had very little association with the likelihood of recommending treatment were unexpected and perhaps deserve further investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>FLS programs and sites as well as all those who manage patients with a fragility fracture can utilize the information derived from this study to improve practice patterns for the care of these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.00665","type":"journal-article","created":{"date-parts":[[2018,4,18]],"date-time":"2018-04-18T19:59:55Z","timestamp":1524081595000},"page":"680-685","source":"Crossref","is-referenced-by-count":23,"title":["Practice Patterns and Performance in U.S. Fracture Liaison Programs"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3774-0569","authenticated-orcid":false,"given":"Douglas R.","family":"Dirschl","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago School of Medicine and Biological Sciences, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Rustom","sequence":"additional","affiliation":[{"name":"College of Osteopathic Medicine, Des Moines University, Des Moines, Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"6","key":"bib1-20230810","first-page":"1389","article-title":"Leadership in orthopaedics: taking a stand to own the bone. American Orthopaedic Association position paper","volume":"87","year":"2005","journal-title":"J Bone Joint Surg Am."},{"issue":"5","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.semarthrit.2005.11.001","article-title":"Fragility fractures and the osteoporosis care gap: an international phenomenon","volume":"35","author":"Giangregorio","year":"2006","journal-title":"Semin Arthritis Rheum."},{"issue":"4","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1046\/j.1365-2796.1996.429781000.x","article-title":"Advances in osteoporosis: better identification of risk factors can reduce morbidity and mortality","volume":"239","author":"Johnell","year":"1996","journal-title":"J Intern Med."},{"issue":"10","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1046\/j.1532-5415.2002.50455.x","article-title":"Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study","volume":"50","author":"Leibson","year":"2002","journal-title":"J Am Geriatr Soc."},{"issue":"3","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1359\/jbmr.061113","article-title":"Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025","volume":"22","author":"Burge","year":"2007","journal-title":"J Bone Miner Res."},{"issue":"12","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1007\/s00198-003-1507-z","article-title":"The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture","volume":"14","author":"McLellan","year":"2003","journal-title":"Osteoporos Int."},{"issue":"3","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1007\/s00198-010-1477-x","article-title":"Targeted intervention reduces refracture rates in patients with incident non-vertebral osteoporotic fractures: a 4-year prospective controlled study","volume":"22","author":"Lih","year":"2011","journal-title":"Osteoporos Int."},{"issue":"1","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s00198-011-1802-z","article-title":"Cost-effectiveness of the Concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study","volume":"23","author":"Cooper","year":"2012","journal-title":"Osteoporos Int."},{"issue":"11","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"2809","DOI":"10.1007\/s00198-013-2368-8","article-title":"Secondary prevention of osteoporotic fractures\u2014an \u201cOPTIMAL\u201d model of care from Singapore","volume":"24","author":"Chandran","year":"2013","journal-title":"Osteoporos Int."},{"issue":"Suppl 3","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s00198-011-1712-0","article-title":"Fracture prevention in Kaiser Permanente Southern California","volume":"22","author":"Dell","year":"2011","journal-title":"Osteoporos Int."},{"issue":"Suppl 3","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s00198-011-1695-x","article-title":"Perspectives on pre-fracture intervention strategies: the Geisinger Health System Osteoporosis Program","volume":"22","author":"Newman","year":"2011","journal-title":"Osteoporos Int."},{"issue":"2","key":"bib12-20230810","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s00198-012-2090-y","article-title":"Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis","volume":"24","author":"Ganda","year":"2013","journal-title":"Osteoporos Int."},{"issue":"1","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2106\/JBJS.G.00682","article-title":"The American Orthopaedic Association\u2019s \u201cOwn the Bone\u201d initiative to prevent secondary fractures","volume":"90","author":"Tosi","year":"2008","journal-title":"J Bone Joint Surg Am."},{"key":"bib14-20230810","first-page":"140","article-title":"Experimental and quasi-experimental designs in prevention research","volume":"107","author":"Snow","year":"1991","journal-title":"NIDA Res Monogr."},{"issue":"3","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1136\/qhc.12.3.215","article-title":"Designing a quality improvement intervention: a systematic approach","volume":"12","author":"van Bokhoven","year":"2003","journal-title":"Qual Saf Health Care."},{"issue":"Suppl 3","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s00198-011-1700-4","article-title":"A T-2 translational research perspective on interventions to improve post-fracture osteoporosis care","volume":"22","author":"Majumdar","year":"2011","journal-title":"Osteoporos Int."},{"issue":"24","key":"bib17-20230810","doi-asserted-by":"crossref","first-page":"e109","DOI":"10.2106\/JBJS.15.01494","article-title":"Own the Bone, a system-based intervention, improves osteoporosis care after fragility fractures","volume":"98","author":"Bunta","year":"2016","journal-title":"J Bone Joint Surg Am."},{"key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"759","DOI":"10.2147\/IJWH.S53489","article-title":"Challenges in implementing and maintaining osteoporosis therapy","volume":"6","author":"Modi","year":"2014","journal-title":"Int J Womens Health."},{"issue":"4","key":"bib19-20230810","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s11914-013-0162-3","article-title":"Fracture liaison services in an open system: how was it done? What were the barriers and how were they overcome?","volume":"11","author":"Chandran","year":"2013","journal-title":"Curr Osteoporos Rep."},{"issue":"19","key":"bib20-20230810","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.2106\/JBJS.N.01275","article-title":"Anti-osteoporotic therapy after fragility fracture lowers rate of subsequent fracture: analysis of a large population sample","volume":"97","author":"Bawa","year":"2015","journal-title":"J Bone Joint Surg Am."},{"issue":"7","key":"bib21-20230810","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.2106\/JBJS.L.01781","article-title":"Declining rates of osteoporosis management following fragility fractures in the U.S., 2000 through 2009","volume":"96","author":"Balasubramanian","year":"2014","journal-title":"J Bone Joint Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201804180-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:42:59Z","timestamp":1787751779000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201804180-00008"}},"subtitle":["An Analysis of &gt;32,000 Patients from the Own the Bone Program"],"short-title":[],"issued":{"date-parts":[[2018,4,18]]},"references-count":21,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.17.00665","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,18]]}}}