The main aim is to assess the effectiveness of introducing a standardized intervention program for treatment of patients with a fragility fracture as measured by changes in the fracture rates and the mortality.
A fracture liaison service model of care is widely recommended but data on its effectiveness regarding reduced risk of recurrent fracture and fracture related mortality are scarce. The investigators therefore aim to assess the risk of subsequent fractures and mortality after a clinical fracture in patients who present to hospitals with a standardized intervention program. Seven Norwegian hospitals will be Stepped Wedge Cluster Randomized to a standardized intervention program with startup date between May 2015 and Jan 2016. The intervention will last throughout 2018 with follow-up throughout 2019. Outcomes before and after the intervention will be compared and each hospital will act as its own control. The effect of the intervention will be measured by using national patient registries on fractures and mortality.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
94,260
Haukeland University Hospital
Bergen, Norway
Drammen Hospital
Drammen, Norway
Molde Hospital
Molde, Norway
Oslo University Hospital
Oslo, Norway
Fragility fracture
Incidence of fragility fractures per 10,000 person-years (distal forearm fractures, proximal humerus fractures and hip fractures)
Time frame: 4 years
Mortality
Total number of deaths during four years after enrollment
Time frame: 4 years
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Bærum Hospital
Sandvika, Norway
University Hospital of North Norway
Tromsø, Norway
St. Olavs University Hospital
Trondheim, Norway