August 27, 2013 Nyon, Switzerland
An influential report published in the journal 'Osteoporosis International', recommends 13 best practice standards in the implementation of coordinator-based fracture liaison services (FLS). The report, 'Capture the Fracture: A Best Practice Framework and Global Campaign to Break the Fragility Fracture Cycle' (1), has been been shaped by input from leaders of established Fracture Liaison Services throughout the world and endorsed by the International Osteoporosis Foundation.
Coordinator-based FLS centre around a coordinator, often a nurse, who acts as a liaison between the patient, orthopaedist, radiologist and family practitioner. Coordinator-based FLS have been shown to close the treatment gap, and are the optimal way for health care providers to identify and manage people at high risk of secondary fractures.
Addressing the treatment gap:
Fragility fractures due to osteoporosis are a major public health problem, resulting in enormous health care costs, disability, or premature death in older adults. Up to 20% of patients die in the first year following hip fractures, and fewer than half of those who survive are able to regain their previous level of function. A patient who has had one fracture is at double the risk of suffering a second, possibly even more serious, fracture. However, as many as 80% of patients who present to a clinic with a fracture are not investigated for osteoporosis, the disease which is often the underlying cause of the fracture. This leaves the patient exposed to a very high risk of secondary fractures – and a future of pain, disability or possibly premature death.
Thirteen standards for best practice in FLS:
The authors of the 'Capture the Fracture' report provide detailed information on 13 key standards: Patient identification; Patient evaluation; Post fracture assessment timing; Vertebral fracture; Assessment guidelines; Secondary causes of osteoporosis; Falls prevention; Multifaceted health and lifestyle risk-factor assessment; Medication initiation; Medication review; Communication strategy; Long-term Management; Database.
Professor Cyrus Cooper, Chair of the IOF Committee of Scientific Advisors, stated, "If systematically identified and treated, patients who have suffered a first fracture stand a good chance of avoiding future debilitating fractures. Furthermore, for the health care system, fracture prevention results in significant cost savings. We hope that the Capture the Fracture best practice framework will assist clinics worldwide to implement effective FLS systems for secondary fracture prevention."
The report, as well as other essential resources and documentation, are available on the Capture the Fracture initiative portal, http://www.capturethefracture.org . Clinics can participate by submitting information about their FLS or coordinator- based programmes for inclusion on an interactive map, which shows the address and location of clinics around the world offering FLS, along with a summary of their achievements in secondary fracture prevention.
To date, 44 clinics have submitted their FLS programmes for review, with numbers rising steadily.
(1) Akesson K, Marsh D, Mitchell P, et al. IOF Fracture Working Group. Capture the Fracture: A Best Practice Framework and Global Campaign to Break the Fragility Fracture Cycle. Osteoporos Int. 2013 http://capturethefracture.org/themes/capture/files/Capture-the-Fracture-position_paper.pdf
About IOF
The International Osteoporosis Foundation (IOF) is the world's largest nongovernmental organization dedicated to the prevention, diagnosis and treatment of osteoporosis and related musculoskeletal diseases. IOF members, including committees of scientific researchers as well as more than 200 patient, medical and research societies, work together to make bone, joint and muscle health a worldwide heath care priority. http://www.iofbonehealth.org; twitter.com/IOFbonehealth; facebook.com/IOFbonehealth
About Capture the Fracture
Capture the Fracture is a multi-stakeholder initiative led by the International Osteoporosis Foundation. The initiative hopes to drive change so that secondary fracture prevention becomes a reality around the world. It aims illustrate global best practice for FLS; set benchmarks to which clinics and hospitals can aspire; provide essential resources and documentation; give international recognition to FLS programmes around the world; and establish mentoring and grant programmes to assist development of FLS at the local level. http://www.capturethefracture.org
For further information contact C. Kyer at ckyer@iofbonehealth.org
Journal
Osteoporosis International