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Fracture Liaison Service

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https://www.readbyqxmd.com/read/29754189/consensus-on-best-practice-standards-for-fracture-liaison-service-in-the-asia-pacific-region
#1
Ding-Cheng Derrick Chan, Lo-Yu Chang, Kristina E Akesson, Paul Mitchell, Chung-Hwan Chen, E Michael Lewiecki, Joon Kiong Lee, Tang Ching Lau, Thawee Songpatanasilp, Kin Bong Lee, Kwang Joon Kim, Jung-Fu Chen, Ko-En Huang, Yih-Lan Gau, Yin-Fan Chang, Peter Ebeling, Weibo Xia, Wei Yu, Atsushi Suzuki, Fen Lee Hew, Leilani B Mercado-Asis, Yoon-Sok Chung, Keh-Sung Tsai, Gau-Tyan Lin, Rong-Sen Yang, Chih-Hsing Wu
The Fracture Liaison Service (FLS) Consensus Meeting endorsed by the International Osteoporosis Foundation (IOF), Asian Federation of Osteoporosis Societies (AFOS), and Asia Pacific Osteoporosis Foundation (APOF) was hosted by the Taiwanese Osteoporosis Association on October 14, 2017. International and domestic experts reviewed the 13 Best Practice Framework (BPF) standards and concluded that all standards were generally applicable in the Asia-Pacific region and needed only minor modifications to fit the healthcare settings in the region...
May 12, 2018: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29747415/patient-related-factors-associated-with-adherence-to-recommendations-made-by-a-fracture-liaison-service-a-mixed-method-prospective-study
#2
Mireille Luc, Hélène Corriveau, Gilles Boire, Johanne Filiatrault, Marie-Claude Beaulieu, Isabelle Gaboury
A Fracture Liaison Service (FLS) has been calculated to be a cost-effective model of care for patients with fragility fracture (FF). Cost-effectiveness can be achieved when adherence to bone health recommendations from FLS staff is high. This prospective study combined participants’ telephone longitudinal survey data (intervention group, n = 354) and interviews with 16 individuals from FLS in three health regions of the province of Quebec (Canada). Participants were recruited between January 2013 and April 2015...
May 9, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29704027/implementation-of-the-western-australian-osteoporosis-model-of-care-a-fracture-liaison-service-utilising-emergency-department-information-systems-to-identify-patients-with-fragility-fracture-to-improve-current-practice-and-reduce-re-fracture-rates-a-12-month
#3
C A Inderjeeth, W D Raymond, A M Briggs, E Geelhoed, D Oldham, D Mountain
Fracture liaison service linked to an emergency department database effectively identifies patients with OP, improves best practice care, reduces recurrent fractures, and improves quality of life (QoL). The next step is to establish cost-effectiveness. This should be seen as the standard model of care. INTRODUCTION: The Western Australian Osteoporosis Model of Care recommends implementation of a fracture liaison service (FLS) to manage patients with minimal trauma fractures (MTFs). This study evaluates the efficacy of a FLS linked to a tertiary hospital emergency department information system (EDIS) in reducing recurrent fractures...
April 27, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29664856/practice-patterns-and-performance-in-u-s-fracture-liaison-programs-an-analysis-of-32-000-patients-from-the-own-the-bone-program
#4
Douglas R Dirschl, Hani Rustom
BACKGROUND: We are not aware of any previous investigation assessing a national cohort of patients enrolled in a fracture liaison service (FLS) program in an open health-care system to ascertain prevalent practice patterns. The objective of this investigation was to determine, in a geographically diverse group of centers in a single FLS program, the percentage of patients for whom anti-osteoporosis treatment was recommended or started as well as to identify associations between patient and fracture variables and the likelihood of treatment being recommended...
April 18, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29605113/disuse-osteopenia-following-leg-fracture-in-postmenopausal-women-implications-for-hip-fracture-risk-and-fracture-liaison-services
#5
S J Hopkins, A D Toms, M Brown, A Appleboam, K M Knapp
INTRODUCTION: Disuse osteopenia is a known consequence of reduced weight-bearing and has been demonstrated at the hip following leg injury but has not been specifically studied in postmenopausal women. METHOD: Bilateral DXA (GE Lunar Prodigy) bone mineral density (BMD) measurements were taken at the neck of femur (NOF), total hip region (TH) and lumbar spine in postmenopausal female groups comprising controls (N = 43), new leg fractures (#<3wks) (N = 9), and participants who had sustained a leg fracture more than one year previously (#>1yr) (N = 24)...
May 2018: Radiography
https://www.readbyqxmd.com/read/29555309/fracture-liaison-services-improve-outcomes-of-patients-with-osteoporosis-related-fractures-a-systematic-literature-review-and-meta-analysis
#6
Chih-Hsing Wu, Shih-Te Tu, Yin-Fan Chang, Ding-Cheng Chan, Jui-Teng Chien, Chih-Hsueh Lin, Sonal Singh, Manikanta Dasari, Jung-Fu Chen, Keh-Sung Tsai
OBJECTIVES: This systematic review and meta-analysis evaluated the outcomes of patients with osteoporosis-related fractures managed through fracture liaison services (FLS) programs. METHODS: Medline, PubMed, EMBASE, and the Cochrane Library were searched (January 2000-February 2017 inclusive) using the keywords 'osteoporosis', 'fractures', 'liaison', and 'service' to identify randomised controlled trials and observational studies of patients aged ≥50years with osteoporosis-related fractures in hospital, clinic, community, or home-based settings who were managed using FLS...
March 16, 2018: Bone
https://www.readbyqxmd.com/read/29553966/subsequent-fracture-prevention-in-patients-50-years-and-older-with-fragility-fractures-a-quality-improvement-initiative
#7
Patricia A Mackey, Laura D Rosenthal, Lanyu Mi, Michael D Whitaker
Because of osteoporosis, patients older than 50 years with fragility fractures are at risk of further fractures. We developed a quality improvement initiative based on an evidence-based Fracture Liaison Service (FLS) model of care to help prevent subsequent fractures. Previous to the implemented FLS model, less than 13% of patients with fragility fractures were assessed for osteoporosis at our institution. We created a registry tool to identify patients with fractures who were older than 50 years. Our interventions focused on identifying, contacting, and educating patients; and coordinating screening tests and an outpatient follow-up visit with an endocrinologist...
March 16, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29546650/the-burden-of-inpatient-care-for-diabetic-and-non-diabetic-patients-with-osteoporotic-hip-fractures-does-it-differ-an-analysis-of-patients-recruited-into-a-fracture-liaison-service-in-southeast-asia
#8
M Chandran, D Tay, X F Huang, Y Hao
Hospital care and mortality of diabetic and non-diabetic osteoporotic Asian patients undergoing hip fracture surgery were explored with no difference in length of hospitalization, incidence of post-operative complications, or mortality between diabetics and non-diabetics seen. Time to operation correlated with post-operative complications occurrence and therefore surgery should be expeditiously done. INTRODUCTION: Whether burden of inpatient care, problems after admission, and mortality rates differ between diabetics and non-diabetics undergoing surgery for osteoporotic hip fractures has not been explored in Asian populations...
March 15, 2018: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29525971/identifying-characteristics-of-an-effective-fracture-liaison-service-systematic-literature-review
#9
REVIEW
C-H Wu, C-H Chen, P-H Chen, J-J Yang, P-C Chang, T-C Huang, S Bagga, Y Sharma, R-M Lin, D-C Chan
Fracture liaison services (FLS) have been demonstrated to improve outcomes following osteoporotic fracture. The aim of this systematic literature review (SLR) was to determine the characteristics of an FLS that lead to improved patient outcomes. We conducted a SLR, including articles published between 2000 and February 2017, using global (Medline, EMBASE, PubMed and Cochrane Library) and local databases. Studies including patients aged ≥ 50 years with osteoporotic fractures enrolled in an FLS were assessed...
May 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29460102/economic-impact-and-cost-effectiveness-of-fracture-liaison-services-a-systematic-review-of-the-literature
#10
REVIEW
C-H Wu, I-J Kao, W-C Hung, S-C Lin, H-C Liu, M-H Hsieh, S Bagga, M Achra, T-T Cheng, R-S Yang
Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016...
February 19, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29429033/implementing-a-fracture-liaison-service-open-model-of-care-utilizing-a-cloud-based-tool
#11
S L Greenspan, A Singer, K Vujevich, B Marchand, D A Thompson, Y-J Hsu, D Vaidya, L S Stern, D Zeldow, D B Lee, S Karp, R Recker
PURPOSE: Although half of women and one-quarter of men aged 50 and older will sustain an acute low-trauma fracture, less than a quarter receive appropriate secondary fracture prevention. The goal of this quality improvement demonstration project was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in three open health care systems aided by a cloud-based tool. METHODS: The pre-post study design examined the proportion of men and women over age 50 who received appropriate assessment (bone mineral density, vitamin D levels) and treatment (calcium/vitamin D, pharmacologic therapy) in the six months following a recently diagnosed fracture...
April 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29376552/impact-of-a-fracture-liaison-service-on-patient-management-after-an-osteoporotic-fracture-the-chuv-fls
#12
Bérengère Aubry-Rozier, Delphine Stoll, Elena Gonzalez Rodriguez, Didier Hans, Veronique Prudent, Ariane Seuret, Alain Farron, Olivier Lamy
In 2008, the Centre Hospitalier Universitaire Vaudois (CHUV, Lausanne, Switzerland) initiated a Fracture Liaison Service (FLS). All patients hospitalised for a low trauma fracture are identified by the FLS. Inpatients then choose to be managed by either the FLS team or their general practitioner (GP). In this study we compared the management between the FLS team and the GP in terms of diagnosis of osteoporosis, treatment, refracture rates and mortality after FLS recording. Results are compared with the management of osteoporosis before the creation of the FLS, as reported in the survey study Osteocare...
January 29, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29285627/fracture-liaison-services-for-osteoporosis-in-the-asia-pacific-region-current-unmet-needs-and-systematic-literature-review
#13
REVIEW
Y -F Chang, C -F Huang, J -S Hwang, J -F Kuo, K -M Lin, H -C Huang, S Bagga, A Kumar, F -P Chen, C -H Wu
The analysis aimed to identify the treatment gaps in current fracture liaison services (FLS) and to provide recommendations for best practice establishment of future FLS across the Asia-Pacific region. The findings emphasize the unmet need for the implementation of new programs and provide recommendations for the refinement of existing ones. The study's objectives were to evaluate fracture liaison service (FLS) programs in the Asia-Pacific region and provide recommendations for establishment of future FLS programs...
April 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29260291/a-dedicated-fracture-liaison-service-telephone-program-and-use-of-bone-turnover-markers-for-evaluating-1-year-persistence-with-oral-bisphosphonates
#14
P van den Berg, P M M van Haard, E van der Veer, P P Geusens, J P van den Bergh, D H Schweitzer
Telephone call intervention did not improve alendronate persistence in Fracture Liaison Service (FLS) patients in this study. A bone turnover marker cut-off point for alendronate persistence is proposed for individual FLS patients. INTRODUCTION: FLS aims to prevent subsequent fractures, which should include improving patients' persistence with prescribed oral bisphosphonates. We studied the influence of telephone calls and the predictive value of changes in bone turnover markers (BTMs) for evaluating persistence with alendronate...
April 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29230540/preventing-future-fractures-effectiveness-of-an-orthogeriatric-fracture-liaison-service-compared-to-an-outpatient-fracture-liaison-service-and-the-standard-management-in-patients-with-hip-fracture
#15
Antonio Naranjo, Sonia Fernández-Conde, Soledad Ojeda, Laura Torres-Hernández, Carolina Hernández-Carballo, Idoia Bernardos, Sinforiano Rodríguez, Pedro Laynez
An observational study was carried out in two hospitals in patients > 65 years admitted for hip fracture. At 6 months, 15% of patients in the hospital with orthogeriatric standard care and 75% in the hospital with fracture liaison service were receiving bisphosphonates. PURPOSE: Many patients with fractures are discharged without preventive therapy against further fractures. We sought to compare the effectiveness of an orthogeriatric fracture liaison service (FLS), outpatient FLS, and the standard care after hip fractures in prevention of future fractures...
December 11, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29224695/fragility-fractures-their-impact-on-older-people
#16
REVIEW
Lídia Sànchez-Riera, Nicholas Wilson
Osteoporotic fractures, in particular hip and vertebral, are a major health burden worldwide. The majority of these fractures occur in the elderly population, resulting in one of the most important causes of mortality and disability in older ages. Their cost for societies is enormous and is forecast to steadily increase over the coming decades globally. Low bone mineral density (BMD) remains a key preventable risk factor for fractures. Screening and treatment of individuals with high risk of fracture is cost-effective...
April 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29197305/internal-medicine-hospitalists-perceived-barriers-and-recommendations-for-optimizing-secondary-prevention-of-osteoporotic-hip-fractures
#17
Eng Keong Tan, Kah Poh Loh, Sarah L Goff
OBJECTIVES: Osteoporosis is a major public health concern affecting an estimated 10 million people in the United States. To the best of our knowledge, no qualitative study has explored barriers perceived by medicine hospitalists to secondary prevention of osteoporotic hip fractures. We aimed to describe these perceived barriers and recommendations regarding how to optimize secondary prevention of osteoporotic hip fracture. METHODS: In-depth, semistructured interviews were performed with 15 internal medicine hospitalists in a tertiary-care referral medical center...
December 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29170857/comorbidities-and-medication-use-in-patients-with-a-recent-clinical-fracture-at-the-fracture-liaison-service
#18
L Vranken, C E Wyers, R Y Van der Velde, H M Janzing, S Kaarsemaker, P P Geusens, J P Van den Bergh
In this cross-sectional study, two-thirds of Fracture Liaison Service (FLS) patients had comorbidities and medications associated with increased bone- or fall-related fracture risk. Bone-related and fall-related fracture risk (BRR and FRR) were associated with age and fracture type, but not with gender or BMD. Systematic evaluation of these factors leads to a more profound assessment in FLS care. INTRODUCTION: This study is a systematic evaluation of comorbidities and medications associated with increased fracture risk in patients aged 50-90 years with a recent fracture visiting the FLS...
February 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29168548/guidelines-for-the-diagnosis-and-management-of-osteoporosis-in-poland-update-2017
#19
Roman Lorenc, Piotr Głuszko, Edward Franek, Mirosław Jabłoński, Maciej Jaworski, Ewa Kalinka-Warzocha, Elzbieta Karczmarewicz, Tomasz Kostka, Krystyna Księzopolska-Orłowska, Ewa Marcinowska-Suchowierska, Waldemar Misiorowski, Andrzej Więcek
In the rapidly ageing society in Poland, osteoporosis is a growing epidemiological problem, and osteoporosis-related fractures are a cause of chronic disability and considerable increase of death risk. It turns out that 80 to 90% of patients suffering from osteoporosis, including osteoporosis accompanied by fractures, do not receive adequate pharmacotherapy. In this paper, a Guideline Working Group of experts from the Multidisciplinary Osteoporosis Forum update the existing Polish guidelines concerning the diagnosis and management of osteoporosis (last revised in 2013), taking account of the latest literature, availability and reimbursement of drugs, and current health care organisation...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/29063214/geisinger-high-risk-osteoporosis-clinic-hiroc-2013-2015-fls-performance-analysis
#20
P Dunn, D Webb, T P Olenginski
Geisinger Health System (GHS) high-risk osteoporosis clinic (HiROC), which treats patients with low-trauma, fragility fractures, reports their 2013-2015 performance measures in secondary fracture prevention. This fracture liaison service (FLS) pathway treats 75% of high-risk, drug eligible patients, compared to 13.8% in GHS primary care. This performance points to the need for more FLS programs throughout the world. INTRODUCTION: The purpose of this study is to analyze and report ongoing performance measures in outpatient and inpatient high-risk osteoporosis clinic (HiROC) program designed for patients with low-trauma, fragility fractures...
February 2018: Osteoporosis International
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