INTRODUCTION: Fracture care often represents the first opportunity for clinical management of osteoporosis; however, many patients do not receive any evaluation after a fracture. In Glasgow, Scotland, fewer than 10% of fracture patients underwent bone mineral density (BMD) testing. In an effort to better meet the needs of fracture patients by providing routine assessment and, where necessary, treatment for osteoporosis after their fracture, a novel service (The Fracture Liaison Service) was designed and implemented in two separate National Health Service trusts in Glasgow. METHODS: An agreed-upon standard of care for men and women 50+ years of age with fractures was established in collaboration with orthopedic surgeons and primary care physicians. The Fracture Liaison Service assumes responsibility for fracture case-finding and for assessing and performing diagnostic evaluations (including axial DXA), and making specific treatment recommendations for the secondary prevention of osteoporotic fractures. RESULTS: During the first 18 months of operation, more than 4,600 patients with fractures of the hip, wrist, humerus, ankle, foot, hand, and other sites were seen by the Fracture Liaison Service's osteoporosis specialist nurses. Nearly three quarters of these patients were considered for BMD testing; treatment was recommended for approximately 20% of the patients without need for BMD testing. Overall, 82.3% of patients who had BMD testing were found to be osteopenic or osteoporotic at the hip or spine. CONCLUSIONS: The Fracture Liaison Service has successfully identified and evaluated most patients with fractures. Only those patients who declined were not evaluated. The ultimate success of the program will be measured by the subsequent fracture experience of these patients, but clear improvements in diagnosing and treating low bone mineral density in patients with fracture have already been demonstrated.
INTRODUCTION:Fracture care often represents the first opportunity for clinical management of osteoporosis; however, many patients do not receive any evaluation after a fracture. In Glasgow, Scotland, fewer than 10% of fracturepatients underwent bone mineral density (BMD) testing. In an effort to better meet the needs of fracturepatients by providing routine assessment and, where necessary, treatment for osteoporosis after their fracture, a novel service (The Fracture Liaison Service) was designed and implemented in two separate National Health Service trusts in Glasgow. METHODS: An agreed-upon standard of care for men and women 50+ years of age with fractures was established in collaboration with orthopedic surgeons and primary care physicians. The Fracture Liaison Service assumes responsibility for fracture case-finding and for assessing and performing diagnostic evaluations (including axial DXA), and making specific treatment recommendations for the secondary prevention of osteoporotic fractures. RESULTS: During the first 18 months of operation, more than 4,600 patients with fractures of the hip, wrist, humerus, ankle, foot, hand, and other sites were seen by the Fracture Liaison Service's osteoporosis specialist nurses. Nearly three quarters of these patients were considered for BMD testing; treatment was recommended for approximately 20% of the patients without need for BMD testing. Overall, 82.3% of patients who had BMD testing were found to be osteopenic or osteoporotic at the hip or spine. CONCLUSIONS: The Fracture Liaison Service has successfully identified and evaluated most patients with fractures. Only those patients who declined were not evaluated. The ultimate success of the program will be measured by the subsequent fracture experience of these patients, but clear improvements in diagnosing and treating low bone mineral density in patients with fracture have already been demonstrated.
Authors: H A Pols; D Felsenberg; D A Hanley; J Stepán; M Muñoz-Torres; T J Wilkin; G Qin-sheng; A M Galich; K Vandormael; A J Yates; B Stych Journal: Osteoporos Int Date: 1999 Impact factor: 4.507
Authors: Maria-Teresa Cuddihy; Sherine E Gabriel; Cynthia S Crowson; Elizabeth J Atkinson; Claudia Tabini; W Michael O'Fallon; L Joseph Melton Journal: Arch Intern Med Date: 2002-02-25
Authors: S T Harris; N B Watts; H K Genant; C D McKeever; T Hangartner; M Keller; C H Chesnut; J Brown; E F Eriksen; M S Hoseyni; D W Axelrod; P D Miller Journal: JAMA Date: 1999-10-13 Impact factor: 56.272
Authors: S Ojeda-Bruno; A Naranjo; F Francisco-Hernández; C Erausquin; I Rúa-Figueroa; J C Quevedo; C Rodríguez-Lozano Journal: Osteoporos Int Date: 2010-10-06 Impact factor: 4.507
Authors: T P Olenginski; G Maloney-Saxon; C K Matzko; K Mackiewicz; H L Kirchner; A Bengier; E D Newman Journal: Osteoporos Int Date: 2014-11-15 Impact factor: 4.507
Authors: Gijs de Klerk; J Han Hegeman; Detlef van der Velde; Job van der Palen; Leo van Bergeijk; Henk J Ten Duis Journal: Geriatr Orthop Surg Rehabil Date: 2013-06