Fracture Liaison Services: Program for coordinated secondary prevention of osteoporotic fractures
Authors:
Pikner Richard 1,2,3; Němec Pavel 4,5; Palička Vladimír 6; Švagr Martin 7; Hejduk Karel 4,5; Šanca Ondřej 4; Budíková Babora 4; Ngo Ondřej 4,5; Jarkovský Jiří 4,5; Májek Ondřej 4,5; Duba Jaroslav 8; Vachek Jan 9
Authors‘ workplace:
Oddělení klinických laboratoří, pracoviště kostního metabolizmu, Klatovská nemocnice a. s., Klatovy
1; Ústav klinické biochemie a hematologie LF UK a FN Plzeň
2; Katedra záchranářství, diagnostických oborů a veřejného zdravotnictví, Fakulta zdravotnických studií Západočeské, univerzity v Plzni
3; Národní screeningové centrum, Ústav zdravotnických informací a statistiky ČR, Brno
4; Institut biostatistiky a analýz LF MU, Brno
5; Osteocentrum, Ústav klinické biochemie a diagnostiky LF UK a FN Hradec Králové
6; Ortopedické oddělení, Klatovská nemocnice a. s., Klatovy
7; OAKS Consulting s. r. o., Praha
8; Interní oddělení, Klatovská nemocnice a. s., Klatovy
9
Published in:
Clinical Osteology 2021; 26(3): 119-132
Category:
Overview
Fracture Liaison Service (FLS) as a tool for secondary prevention of osteoporotic fractures has been proven to increase effectivity of patients´ care after osteoporotic fracture. FLS in Klatovy Hospital increased 6 times number of DXA measurements and 4-times the number of treated patients within first 6 months of implementation. There have been started 2 FLS projects in the Czech Republic in 2021. National pilot multicentric study OSTEO with 10 active participating centers verifying implementation of FLS protocols in the Czech Republic. Next project is „Q–osteoporosis“. This is pilot project to improve quality of osteoporosis care by outpatient internists. They will get more reimbursement per patient if patient is treated according to the study protocol based on principle of Identify – Investigate – Intervene – Inform (4I) and FLS both in primary and secondary osteoporosis prevention. These projects and similar ones are only the way how to improve treatment a care gap that was 96 % in patients with proximal femoral fracture in the Czech Republic in 2016.
Keywords:
fracture liaison service – low trauma fracture – osteoporosis – secondary prevention
Sources
- Kanis JA, Johansson H, Cooper C et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2013; 24(1): 23–57. Dostupné z DOI: <https://doi.org/10.1007/s00198–012–2074-y>.
- Pikner R, Palička V, Vyskocil V et al. Definice osteoporotické (křehké) zlomeniny: stanovisko Společnosti pro metabolická onemocnění skeletu České lékařské společnosti J. E. Purkyně (SMOS ČLS JEP). Clin Osteol 2020; 25(2): 83–84.
- Svedbom A, Hernlund E, Ivergård M et al. Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos 2013; 8 (1): 1 37. D ostupné z DOI: < https://doi.org/10.1007/s11657–013–0137–0>.
- Stepan J, Vaculik J, Pavelka K et al. Hip Fracture Incidence from 1981 to 2009 in the Czech Republic as a Basis of the Country-Specific FRAX Model. Calcif Tissue Int 2012; 90(5) :365–372. Dostupné z DOI:<https://doi.org/10.1007/s00223–012–9582–9>.
- Kanis JA, Johnell O, De Laet C et al.A meta-analysis of previous fracture and subsequent fracture risk. Bone 2004; 35(2): 375–382. Dostupné z DOI: <https://doi.org/10.1016/j.bone.2004.03.024>.
- Edwards BJ, Bunta AD, Simonelli C et al. Prior fractures are common in patients with subsequent hip fractures. Clin Orthop Relat Res 2007; 461:226–230. Dostupné z DOI: <https://doi.org/10.1097/BLO.0b013e3180534269>.
- Boonen S, Autier P, Barette M et al. Functional outcome and quality of life following hip fracture in elderly women: a prospective controlled study. Osteoporos Int 2004; 15(2): 87–94. Dostupné z DOI: <https://doi.org/10.1007/s00198–003–1515-z>.
- Kanis JA, Cooper C, Rizzoli R et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos I nt 2 019; 3 0(1): 3 –44. D ostupné z DOI: < https://doi.org/10.1007/s00198–018–4704–5>.
- Bessette L, Ste-Marie LG, Jean S et al. The care gap in diagnosis and treatment of women with a fragility fracture. Osteoporos Int 2008; 19(1): 79–86. Dostupné z DOI: <https://doi.org/10.1007/s00198–007–0426–9>.
- Borgström F, Karlsson L, Ortsäter G et al. Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 2020; 1 5(1): 5 9. D ostupné z DOI: < https://doi.org/10.1007/s11657–020–0706-y>.
- Štěpán J, Vaculík J, Palička V et al. Péče o pacienty s nízkotraumatickou zlomeninou horního konce stehenní kosti.II. Následná osteologická péče.Doporučený postup České revmatologické společnosti, Společnosti pro metabolická onemocnění skeletu a České společnosti pro ortopedii a traumatologii. Čes Revmatol 2015; 23(2): 43–58.
- Lukáš P, Švagr M, Pikner R. Fracture Liaison Service jako možný nástroj na zlepšení péče – zhodnocení zlomenin proximálního femuru a provedení denzitometrického vyšetření v letech 2012–2016 v Klatovské nemocnici a.s. Osteologický Bulletin 2017; 22(4): 109–112.
- Åkesson KE, McGuigan FE. Closing the Osteoporosis Care Gap. Curr Osteoporos Rep 2021; 19(1): 58–65. Dostupné z DOI: <https://doi.org/10.1007/s11914–020–00644-w>.
- Ganda K. Fracture liaison services: past, present and future. Osteoporos I nt 2 021; 3 2(8): 1 461–1464. D ostupné z DOI: < https://doi.org/10.1007/s00198–021–05982–8>.
- McLellan AR, Gallacher SJ, Fraser M et al.The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 2013; 14(12): 1028–1034. Dostupné z DOI: <https://doi.org/10.1007/s00198–003–1507-z>.
- Akesson K, Marsh D, Mitchell PJ et al. Capture the Fracture: a Best Practice Framework and global campaign to break the fragility fracture cycle. Osteoporos Int 2013; 24(8): 2135–2152. Dostupné z DOI: <https://doi.org/10.1007/s00198–013–2348-z>.
- Capture the Fracture. Dostupné z WWW: <https://www.capturethefracture.org/>.
- Javaid MK. Efficacy and efficiency of fracture liaison services to reduce the risk of recurrent osteoporotic fractures. Aging Clin Exp Res 2021; 3 3(8): 2 061–2067. D ostupné z DOI: < https://doi.org/10.1007/s40520–021–01844–9>.
- Li N, Hiligsmann M, Boonen A et al. The impact of fracture liaison services on subsequent fractures and mortality: a systematic literature review and meta-analysis. Osteoporos Int 2021; 32(8): 1517–1530. Dostupné z DOI: <https://doi.org/10.1007/s00198–021–05911–9>.
- Drew S, Judge A, Cooper C et al. Secondary prevention of fractures after hip fracture: a qualitative study of effective service delivery. Osteoporos Int 2016; 27(5): 1719–1727. Dostupné z DOI: <https://doi.org/10.1007/s00198–015–3452-z>.
- Capture the Fracture. Dostupné z WWW: <https://www.capturethefracture.org/map-of-best-practice>.
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Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology OsteologyArticle was published in
Clinical Osteology
2021 Issue 3
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