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. 2023 Oct 10;9(10):e20838.
doi: 10.1016/j.heliyon.2023.e20838. eCollection 2023 Oct.

The effectiveness of fracture liaison services in patients with hip fractures: A systematic review and meta-analysis of randomized controlled trials

Chengli Yan  1 , Yuyu Chen  1 , Jia Cao  2 , Kai Fang  3 , Lifang Shao  1 , Yaping Luo  1 , Lili Yang  1
Affiliations

The effectiveness of fracture liaison services in patients with hip fractures: A systematic review and meta-analysis of randomized controlled trials

Chengli Yan et al. Heliyon. .

Abstract

Background: In recent years, fracture liaison services (FLS) have been applied for hip fractures; however, their effectiveness remains uncertain.

Objective: To evaluate the effectiveness of FLS in patients with hip fractures.

Design: A systematic review and meta-analysis of randomized controlled trials.

Data sources: Embase, PubMed, Cochrane Library, Ebsco, Ovid, Web of Science, Medline, CNKI, Wangfang, and Vip were searched from their date of inception to March 2023. Two researchers screened the literature based on the inclusion and exclusion criteria, evaluated the quality, extracted data, and conducted a meta-analysis using ReviewManager 5.4.

Results: After screening, 12 randomised controlled trials (RCT) including 2136 patients were used in the meta-analysis. The primary outcomes were hip function rate of recurrent fracture, medication adherence, and degree of weakness. FLS improved hip function in patients with hip fractures [MD = 9.37, 95 % CI (7.69, 11.06), P < 0.0001], P < 0.0001], medication adherence [OR = 10.59, 95 % CI (1.64, 68.41), P＜0.0001], degree of weakness [MD = -1.45, 95%CI (-1.68，-1.23), P＜0.0001], and reduced the rate of recurrent fractures [OR = 0.60, 95 % CI (0.44, 0.82).

Conclusion: Implementation of the FLS management model was beneficial for patients with hip fractures. It can positively impact the prognosis of patients with hip fractures by improving hip function, reducing the rate of recurrent fractures, and improving medication adherence and degree of weakness.

Keywords: Fracture liaison service; Hip fracture; Meta-analysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Search strategy adopted throughout the databases, Pubmed is shown in this instance.
Fig. 2
Fig. 2
Flow diagram of included studies.
Fig. 3
Fig. 3
Risk of bias in the included studies.
Fig. 4
Fig. 4
Impact of FLS on hip function in patients with hip fracture.
Fig. 5
Fig. 5
Subgroup analysis of the effect of different follow-up times on hip function in patients with hip fracture.
Fig. 6
Fig. 6
Results of subgroup analysis of the effects of different intervention forms on hip function in patients with hip fracture.
Fig. 7
Fig. 7
Influence of FLS on the rate of recurrent hip fracture.
Fig. 8
Fig. 8
Impact of FLS on medication adherence in patients with hip fracture.
Fig. 9
Fig. 9
Effects of FLS on frailty in hip fracture patients.
See this image and copyright information in PMC

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