A Fracture Liaison Service (FLS) has been calculated to be a cost-effective model of care\nfor patients with fragility fracture (FF). Cost-effectiveness can be achieved when adherence to bone\nhealth recommendations from FLS staff is high. This prospective study combined participants�\ntelephone longitudinal survey data (intervention group, n = 354) and interviews with 16 individuals\nfrom FLS in three health regions of the province of Quebec (Canada). Participants were recruited\nbetween January 2013 and April 2015. Regression models were fit to examine the relationship\nbetween participant-related factors and adherence at 12 months to osteoporosis medication, vitamin\nD supplementation, and participation in physical activity. Participants acknowledging FF as a\nconsequence of osteoporosis were more likely to adhere to medication (odds ratio (OR) 2.5; p = 0.001)\nand vitamin D supplementation (OR 2.3; p = 0.01). Paradoxically, the same participants were less\nprone to engage in physical activity (OR 0.5, p = 0.01). Qualitative interviews suggested that feedback\nfrom FLS coordinators helped participants understand the underlying cause of their FF. This study\nhighlighted the key roles of FLS staff in helping patients to recognize FF as a sign of underlying bone\ndisease and encouraging adherence to care recommendations.
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