# Implementation of a Modified Fracture Liaison Service at Aarhus University Hospital: A 2-Year Retrospective Cohort Study

## TL;DR

A modified fracture liaison service at Aarhus University Hospital successfully identified patients with fragility fractures and diagnosed osteoporosis in 22% of them.

## Contribution

A modified fracture liaison service was implemented with limited resources and demonstrated success in identifying high-risk patients.

## Key findings

- 22% of patients identified through the program were diagnosed with osteoporosis.
- 65% of patients were potentially eligible for bone anabolic treatment.
- The program ensured successful collaboration with primary care physicians.

## Abstract

Fragility fractures are a consequence of osteoporosis and the strongest indicator of sustaining a future fracture. Effective fracture prevention strategies are therefore needed to reduce the incidence of fragility fractures. Fracture Liaison Services (FLS) are globally recognized as the most effective approach. Inspired by their success, the Danish Health Authority recommended nationwide implementation of prevention programs. With limited funding, the fracture prevention program at Aarhus University Hospital (AUH) was established in 2022 as a modified version. Here, we describe the implementation with focus on patient capture, treatment uptake, collaboration with primary care physicians, and implementation challenges. A retrospective single-center cohort study was conducted. We retrieved information from the hospital registries. Eligible patients were those ≥ 50 years of age who sustained a fracture of the hip, pelvis, spine, distal forearm, or shoulder. Twenty-four months after the implementation, 2363 patients with a fracture were identified. Excluding patients not eligible for the program (n = 1096, 46%), 890 DXAs were performed. Patients diagnosed with osteoporosis following their attendance in the program accounted for 22% (n = 198). Sixty-five percent were potentially eligible for bone anabolic treatment. The fracture prevention program has systematized the identification of patients presenting with a fragility fracture, and identified osteoporosis in 22% of the patients, and ensured a successful collaboration with the primary care physicians. Despite lacking some components of a full FLS, we have demonstrated that it is possible to successfully establish an FLS modified according to available resources and identify patients at high risk of future fractures.

The online version contains supplementary material available at 10.1007/s00223-026-01478-x.