1243 - Bone Voyage: Setting a New Course for Osteoporosis Intervention in Acute Rehab

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

CA

Courtney Aronica, DO

Resident Physician
Northwell Health
Commack, New York, United States
RC

Roy F. Chen, MD, MS

Resident
Northwell Health
Westbury, New York, United States

Co-Author(s)

SM

Susan Maltser, DO

Vice chair , PM&R
Northwell Health
Hollis, New York, United States
WP

Welmince Pello, MPH

Senior Clinical Research Coordinator
Feinstein Institute for Medical Research, Northwell Health
New York City, New York, United States

Submitter(s)

CA

Courtney Aronica, DO

Northwell Health
Commack, New York, United States

Objectives: Osteoporotic fractures in older adults are common, costly, and associated with high rates of recurrence. Oral bisphosphonates can reduce fracture risk and are considered first-line treatment. Despite effective therapies, osteoporosis frequently goes undertreated after hospital discharge: a care gap acute rehabilitation can help address. This study aimed to assess the feasibility and efficacy of implementing a structured intervention to initiate oral bisphosphonates during acute rehab following fragility fracture.

Design: From February 2024 to February 2025, adults admitted to acute rehab following fragility fracture received lab work to screen for calcium / vitamin D deficiency and endocrine dysfunction. They were then evaluated for oral bisphosphonate candidacy. Candidates were offered bedside education and a trial of alendronate in rehab. Enrollees received a 4-week supply of alendronate upon discharge with outpatient follow-up and phone check-ins at 1, 3, 6, and 12 months. Outcome measures included medication continuation and fragility fracture recurrence.

Results: Among 148 screened admissions, 77 were deemed appropriate for alendronate, and 42 enrolled. At 1 month follow-up, 19 of 28 successfully contacted enrollees (68%) remained on alendronate. There was a slight drop in continuation rates at later time points: 55% (11/20) at 3 months, 42% (8/19) at 6 months, and 44% (7/16) at 12 months. Two patients experienced new fragility fractures within 3 months. Common reasons for discontinuation included lack of refill, personal preference to reduce medications, and deferral pending follow-up studies. Minimal side effects were reported: one patient experienced nausea after the first dose, and one discontinued between 3 and 6 months due to unspecified intolerance.

Conclusions: Starting alendronate during acute rehab is feasible and generally well-tolerated. Sustained post-discharge adherence is limited by follow-up attrition, provider communication gaps, and insurance barriers. Continued efforts to initiate early osteoporosis management and coordinate care with outpatient providers may improve treatment adherence and reduce recurrent fracture risk.