Alarm Services as a Useful Tool for Diagnosis and Management of Osteoporosis in Patients with Hip Fractures: A Prospective Observational Multicenter Study

Abstract

Background: Alarm services in the Order Communication System improve awareness for related physicians including orthopaedic surgeons, internal medicine doctors, and other relevent doctors. This prospective observational multicenter study was to compare the diagnostic and treatment rates of osteoporosis between an alarm service group and a no alarm service group. Methods: From January 2017 to december 2017, The subjects included patients aged 50 years or older with hip fractures from 16 hospital-based multicenter cohorts. Among the 16 hospitals, 5 university hospitals established an alarm service for osteoporosis management (i.e., Alarm group) and 11 university hospitals did not setup alarm services (i.e., Control group). The rate of dual energy X-ray absorptiometry (DXA) test and the initiation rate of antiosteoporosis medications between the 2 groups were compared at enrollment and at 6 months follow-up. Results: During the study period, 1,405 patients were enrolled. The DXA examination rate and initiation rate of osteoporosis treatment between the Alarm group and the Control group were 484 patients (89.8%) vs. 642 patients (74.1%) (P<0.001) and 355 patients (65.9%) versus 294 patients (33.9%) (P<0.001), respectively. At 6 months follow-up, the rate of anti-osteoporosis management between the 2 groups decreased (57.8% vs. 29.4%). Conclusions: This prospective multicenter study demonstrates that alarm services can improve awareness of physicians, and it resulted in a significantly higher rate of examination of DXA and initiation of anti-osteoporosis medication in the Alram group. Therefore, alarm service is a simple and effective tool to increase anti-osteoporosis management as part of the fractuure liaison service in South Korea.

Fracture Liaison Service in Korea: 2022 Position Statement of the Korean Society for Bone and Mineral Research

“…In a multicenter trial, the alarm services to increase the diagnosis rate of osteoporosis and prescription rate of anti-osteoporosis medication have been adopted in hip fracture patients who visited emergency room or outpatient clinic. [ 18 ] The diagnostic code of hip fracture activates this service, and whenever the medical staff checks the patients’ medical records, a pop-up reminds them not to omit osteoporosis treatment. It has been proven that the evaluation rate of osteoporosis and the prescription rate of osteoporosis medication increased through the alarm service.…”

Osteoporosis Feature Selection and Risk Prediction Model by Machine Learning Using a Cross-Sectional Database

“…[ 4 ] In busy outpatient clinics, it is easy for medical staff to miss out on the evaluation and management of osteoporosis. [ 5 ] Therefore, preventing or diagnosing osteoporosis early may be more effective than treating osteoporosis after disease progression or osteoporotic fractures occur.…”