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Fracture Liaison Service

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https://www.readbyqxmd.com/read/28812252/secondary-fracture-prevention-in-hip-fracture-patients-requires-cooperation-from-general-practitioners
#1
Jan Vaculík, Jan J Stepan, Pavel Dungl, Marek Majerníček, Alexander Čelko, Valér Džupa
Despite individual recommendations on osteoporosis management in patients after hip fracture surgery, addressed by orthopedic surgeons to Czech general practitioners, the patients remained undiagnosed and untreated because of provider-level barriers to post-fracture secondary prevention. PURPOSE: The goal of the study was to assess whether an individual recommendation on osteoporosis treatment addressed to a hip fracture patient's GP would lead to better osteoporosis management. METHODS: Two groups of patients who suffered hip fractures and were treated at the Orthopedic Department were evaluated...
May 18, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28748385/effect-of-implementation-of-guidelines-on-assessment-and-diagnosis-of-vertebral-fractures-in-patients-older-than-50%C3%A2-years-with-a-recent-non-vertebral-fracture
#2
R Y van der Velde, S P G Bours, C E Wyers, W F Lems, P P M M Geusens, J P W van den Bergh
We evaluated the impact of a new Dutch guideline on systematic implementation of densitometric Vertebral Fracture Assessment (VFA) in patients with a recent non-vertebral fracture. Systematic implementation resulted in a significant increase of VFA, diagnosis of vertebral fractures (VFs), and percentage of patients eligible for treatment. INTRODUCTION: VFs are underdiagnosed although they are important predictors of fracture risk, independent of age and bone mineral density (BMD). The Dutch guideline on osteoporosis and fracture prevention recommends VFA in all patients aged >50 years with a recent non-VF...
July 26, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28740525/the-use-of-cholecalciferol-in-patients-with-hip-fracture
#3
Luisella Cianferotti, Simone Parri, Giorgio Gronchi, Roberto Civinini, Maria Luisa Brandi
INTRODUCTION: Major osteoporotic fractures are steadily increasing due to population aging. Programs of secondary prevention against refracture are essential to decrease morbidity and mortality and the cost for individuals and the society. Vitamin D supplementation and optimization of calcium intake are of a pivotal importance to start specific osteoporosis treatment and for its safety and efficacy. Cholecalciferol is the most widely employed drug for vitamin D supplementation. PURPOSE: Aim of this study was to assess the trends in the use of vitamin D supplements containing cholecalciferol in the population of hip fracture patients older than 65 years, resident in the region of Tuscany (Italy) in the years 2011-2015 and to describe vitamin D status in a subgroup of this individuals directly referred to a bone clinic for further evaluation after hip osteoporotic fracture...
January 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28717402/fracture-liaison-services-do-they-reduce-fracture-rates
#4
REVIEW
Irma J A de Bruin, Caroline E Wyers, Joop P W van den Bergh, Piet P M M Geusens
The fracture liaison service (FLS) care is considered the most appropriate organizational approach for secondary fracture prevention. We performed a literature search to evaluate to what extent the introduction of a FLS reduced subsequent fracture rates. We identified five studies that compared subsequent fracture rates. These studies varied in study design, proportion of women, baseline and subsequent fracture type [vertebral fracture (VF), non-VF (NVF) or hip fractures], duration of follow-up, response rates of attending the FLS, as well as variables included in adjusted analyses (age, sex, baseline fracture, time dependency)...
July 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28710719/fragility-fractures-at-auckland-city-hospital-we-can-do-better
#5
Geoffrey Braatvedt, Susan Wilkinson, Marilyn Scott, Paul Mitchell, Roger Harris
This study describes in detail the burden of caring for patients aged ≥ 50 years seen in one year with a fragility fracture in a large urban environment and shows that these fractures result in a long length of stay and significant mortality. Intervention to prevent further fracture was poorly done. PURPOSE: To examine the epidemiology of fragility fracture in patients over age 50 years and record the number who received appropriate secondary prevention treatment. METHODS: All patients aged ≥ 50 years presenting with a fracture during the 12 months following July 1(st) 2011, to Auckland City Hospital or residing in central Auckland at the time of their fracture, were identified from hospital and Accident Compensation Corporation records...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28618161/prevention-of-osteoporotic-refractures-in-regional-australia
#6
Emily Davidson, Alexa Seal, Zelda Doyle, Kerin Fielding, Joe McGirr
OBJECTIVE: Clinical guidelines recommend that patients who sustain a minimal trauma fracture (MTF) should receive a bone mineral density (BMD) scan and bisphosphonate (or equivalent) therapy if diagnosed with osteoporosis. A pilot fracture liaison service (FLS) was implemented in regional NSW to improve adherence to the guidelines. DESIGN: Prospective cohort study with an historical control. SETTING: Primary care. PARTICIPANTS: Control (n = 47) and cohort (n = 93) groups comprised patients consenting to interview who presented with a MTF to the major referral hospital 4 months before and 12 months after FLS implementation respectively...
June 15, 2017: Australian Journal of Rural Health
https://www.readbyqxmd.com/read/28536889/the-phenotype-of-patients-with-a-recent-fracture-a-literature-survey-of-the-fracture-liaison-service
#7
REVIEW
Lisanne Vranken, Caroline E Wyers, Joop P W van den Bergh, Piet P M M Geusens
The aetiology of fractures in patients aged 50 years and older is multifactorial, and includes bone- and fall-related risks. The Fracture Liaison Service (FLS) is recommended to identify patients with a recent fracture and to evaluate their subsequent fracture risk, in order to take measures to decrease the risk of subsequent fractures in patients with a high risk phenotype. A literature survey was conducted to describe components of the bone- and fall-related phenotype of patients attending the FLS. Components of the patient phenotype at the FLS have been reported in 33 studies...
September 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28509822/fracture-prevention-in-the-orthopaedic-environment-outcomes-of-a-coordinator-based-fracture-liaison-service
#8
Earl R Bogoch, Victoria Elliot-Gibson, Dorcas Beaton, Joanna Sale, Robert G Josse
BACKGROUND: Fracture liaison services focus on secondary fracture prevention by identifying patients at risk for future fracture and initiating appropriate evaluation, risk assessment, education, and therapeutic intervention. This study describes key clinical outcomes including bone mineral densitometry, physician assessment, and pharmacotherapy initiation in pharmacotherapy-naïve patients undergoing treatment for fragility fracture in a Canadian fracture liaison service. METHODS: We determined rates of post-fracture investigation and treatment for inpatients and outpatients with a fragility fracture seen in a coordinator-based fracture liaison service at an urban university trauma hospital...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28479495/adjusting-frax%C3%A2-on-tbs-for-identification-of-subjects-at-high-risk-of-fractures
#9
G Couraud, C Souffir, E Gaigneux, S Kolta, C Roux, K Briot
The objective of this study was to compare the proportion of patients at high fracture risk according to FRAX® and FRAX® adjusted on TBS in patients hospitalized for a non vertebral fractures. Patients were selected from a Fracture Liaison Service FLS): clinical risk factors, bone mineral density (BMD) and TBS were assessed at the time of the fracture. Without considering the current fracture, we calculated FRAX® and FRAX® adjusted on TBS (TBS-FRAX®), and compared the proportion of patients with a high risk for major osteoporotic fracture (MOF)>20% according to FRAX® and TBS-FRAX®, and the proportion of subjects who should be treated according to current guidelines...
August 2017: Bone
https://www.readbyqxmd.com/read/28473651/how-well-are-we-managing-fragility-hip-fractures-a-narrative-report-on-the-review-with-the-attempt-to-setup-a-fragility-fracture-registry-in-hong-kong
#10
K S Leung, W F Yuen, W K Ngai, C Y Lam, T W Lau, K B Lee, K M Siu, N Tang, S H Wong, W H Cheung
INTRODUCTION: In setting up a disease registry for fragility fractures in Hong Kong, we conducted a retrospective systematic study on the management of fragility hip fractures. Patient outcomes were compared with the standards from our orthopaedic working group and those from the British Orthopaedic Association that runs a mature fracture registry in the United Kingdom. METHODS: Clinical data on fragility hip fracture patients admitted to six acute major hospitals in Hong Kong in 2012 were captured...
May 5, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28426444/fracture-liaison-services
#11
Karine Briot
PURPOSE OF REVIEW: The purpose of this review is to report the evidence of beneficial effects of Fracture Liaison Service (FLS) including data regarding their impact on subsequent fracture, mortality risk and cost-effectiveness. This review also discusses the limitations of these data and the challenges faced during the implementation of FLS. RECENT FINDINGS: Recent studies showed the beneficial impact of implementation of FLS on the prevention of subsequent fracture risk, reduced mortality and cost-effectiveness...
July 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28389970/osteoporosis-a-discussion-on-the-past-5%C3%A2-years
#12
REVIEW
Kyle M Schweser, Brett D Crist
PURPOSE OF THE REVIEW: The purposes of this study are to examine the literature within the past 5 years regarding osteoporosis and offer a discussion on new topics and controversies. RECENT FINDINGS: Patient compliance with therapy remains an issue. The effectiveness of Vitamin D and calcium are being called into question Atypical femur fractures have been associated with bisphosphonate and denosumab use. Treatment is both surgical and pharmaceutical. A multidisciplinary approach to osteoporotic fractures is important and having some form of fracture liaison service (FLS) improves the efficacy of osteoporotic care and decreases secondary fractures...
June 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28285742/peripheral-quantitative-computed-tomography-pqct-measures-contribute-to-the-understanding-of-bone-fragility-in-older-patients-with-low-trauma-fracture
#13
Hongyuan Jiang, Christopher J Yates, Alexandra Gorelik, Ashwini Kale, Qichun Song, John D Wark
Dual-energy X-ray absorptiometry (DXA) as currently used has limitations in identifying patients with osteoporosis and predicting occurrence of fracture. We aimed to express peripheral quantitative computed tomography (pQCT) variables of patients with low-trauma fracture as T-scores by using T-score scales obtained from healthy young women, and to evaluate the potential clinical utility of pQCT for the assessment of bone fragility. Fracture patients were recruited from a fracture liaison service at the Royal Melbourne Hospital...
March 9, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28275838/economic-evaluation-of-a-population-based-osteoporosis-intervention-for-outpatients-with-non-traumatic-non-hip-fractures-the-catch-a-break-1i-type-c-fls
#14
S R Majumdar, D A Lier, D A Hanley, A G Juby, L A Beaupre
Fracture liaison services (FLS) are advocated to improve osteoporosis treatment after fragility fracture, but there are few economic analyses of different models. A population-based 1i [=type C] FLS for non-hip fractures was implemented and it costs $44 per patient and it was very cost-effective ($9200 per QALY gained). Small operational changes would convert it from cost-effective to cost-saving. INTRODUCTION: After fragility fracture, <20% of patients receive osteoporosis treatment...
June 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28247259/vertebral-fracture-assessment-in-patients-presenting-with-a-non-hip-non-vertebral-fragility-fracture-experience-of-a-uk-fracture-liaison-service
#15
Aina Capdevila Reniu, Terence Ong, Syed Ajmal, Opinder Sahota
Twenty-five percent of patients with a non-hip non-vertebral fragility fracture have an undiagnosed vertebral fracture detected by vertebral fracture assessment during bone densitometric assessment. The prevalence of an undiagnosed vertebral fracture is higher in older people, and they are more likely to have multiple vertebral fractures. PURPOSE: Most vertebral fragility fractures (VFF) have no history of trauma. Vertebral fracture assessment (VFA) during dual energy x-ray absorptiometry (DXA) can be used to detect these VFFs...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28155836/fracture-liaison-services-polish-experience-methods-of-secondary-prevention-of-osteoporotic-fractures
#16
Jarosław Amarowicz, Edward Czerwiński, Katarzyna Zając, Anna Kumorek
BACKGROUND: Fragility fractures are a major challenge to health systems around the world. The risk of a subsequent fracture may increase even 11-fold after one's first fracture event. A coordinator-based system (Fracture Liaison Services) was established in Poland in order to fill the gap in the care of patients with osteoporotic fractures. In the past years, the FLS has become a crucial part of orthopaedic facilities worldwide, bringing benefits to patients and savings to health systems' budgets...
November 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28155141/compliance-to-the-joint-commission-proposed-core-measure-set-on-osteoporosis-associated-fracture-review-of-different-secondary-fracture-prevention-programs-in-an-open-medical-system-from-2010-to-2015
#17
Ma Conchitina Fojas, Lauren T Southerland, Laura S Phieffer, Julie A Stephens, Tanya Srivastava, Steven W Ing
There are care gaps in the evaluation and treatment of osteoporosis after a fragility fracture. The Joint Commission is considering adoption of core measures. We compared compliance between two secondary fracture prevention programs in our institution. Incorporating strengths of both may provide the best outcomes for secondary fracture prevention. PURPOSE: There are significant care gaps in the evaluation and treatment of osteoporosis after occurrence of fragility fracture. The Joint Commission is considering adoption of a core measure set on osteoporosis-associated fractures, including laboratory assessment, bone density testing, and osteoporosis pharmacologic therapy...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28138228/fracture-liaison-services-improving-outcomes-for-patients-with-osteoporosis
#18
REVIEW
Samuel Walters, Tanvir Khan, Terence Ong, Opinder Sahota
Fragility fractures are sentinels of osteoporosis, and as such all patients with low-trauma fractures should be considered for further investigation for osteoporosis and, if confirmed, started on osteoporosis medication. Fracture liaison services (FLSs) with varying models of care are in place to take responsibility for this investigative and treatment process. This review aims to describe outcomes for patients with osteoporotic fragility fractures as part of FLSs. The most intensive service that includes identification, assessment and treatment of patients appears to deliver the best outcomes...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28093017/the-bone-health-team
#19
Phillip T Lawrence, Marissa P Grotzke, Yanina Rosenblum, Richard E Nelson, Joanne LaFleur, Karla L Miller, Junjie Ma, Grant W Cannon
BACKGROUND: Significant improvements in secondary prevention of osteoporotic fractures have been noted with fracture liaison services. However, similar models for the primary prevention of such fractures have not been reported. OBJECTIVE: To determine the impact of a Bone Health Team (BHT) on osteoporosis screening and treatment rates in U.S. veterans in primary care practices. DESIGN: Historical cohort study of a primary care-based intervention of a BHT from February 2013 to February 2015...
January 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28004297/evaluation-of-the-first-fracture-liaison-service-in-the-greek-healthcare-setting
#20
Polyzois Makras, Maria Panagoulia, Andriana Mari, Stavroula Rizou, George P Lyritis
We evaluated the first implementation of FLS in the Greek healthcare setting, at the 251 Hellenic Air Force and VA General Hospital of Athens. Participation rate was moderate (54.5%) and needs improvement; osteoporosis medication was either suggested or reviewed in 74 out of the 116 patients recruited. PURPOSE: The purpose of this study was to evaluate the first implementation of a fracture liaison service (FLS) in Greece, at the 251 Hellenic Air Force and VA General Hospital, Athens...
December 2017: Archives of Osteoporosis
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