• Chirn-Bin Chang, Rong-Sen Yang, Wei-Jia Huang, Yi-Chun Chou, Chiung-Jung Wen, Ting-Chun Huang, Ming-Chang Chen, and Ding-Cheng Chan.
• Department of Internal Medicine, National Taiwan University BioMedical Park Hospital, Chu-Tung Campus, Hsinchu County, Taiwan; Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
• J Formos Med Assoc. 2023 Aug 1; 122 (8): 690698690-698.

BackgroundA fracture liaison services (FLSs) and its modified services reduce refractures and mortality and can be cost-effective. Limited studies have addressed whether urban-rural differences exist in vertebral fracture outcomes and management. Therefore, the aims of the study were to investigate any urban-rural differences in refracture, mortality, prescription pattern, and associated factors of vertebral fractures after receiving assistance from an FLSs.MethodsBaseline characteristics and osteoporosis medication prescription patterns of participants were collected. After 1-year follow-up, mortality, refracture rate, and osteoporosis medication switching and adherence were evaluated. Multivariate logistic regressions were performed to identify baseline correlates on one-year mortality.ResultsThere was higher mortality rate in the rural group but no urban-rural difference in the 1-year refracture rate after implementation of FLSs and medication management services (MMSs). The types of osteoporosis medications prescribed for both groups were similar, but participants in the rural group were less likely to change their osteoporosis medications during the 1-year follow-up timeframe and with lower adherence rate. The likelihood of being older and having chronic kidney disease, osteoarthritis, and neurological disease was higher in the rural group.ConclusionOur multicomponent services have similar effectiveness in osteoporosis treatment between urban and rural areas. The overall adherence rate was lower in the rural group with higher mortality but no difference in the refracture rate in one year.Copyright © 2022 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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