Bernardo Stolnicki1,2, André Manoel Inácio3,4, Karina Kuraoka Tutiya1,5, Luiz Fernando Tikle Vieira1,6, M Kassim Javaid7, Monica Caló8. 1. IOF Capture the Fracture® FLS Mentors Group, São Paulo, SP, Brazil. 2. Coordenador FLS Prevrefrat - Hospital Federal de Ipanema, CREB E Policlínica Fiosaúde, Rio de Janeiro, RJ, Brazil. 3. IOF Capture the Fracture® FLS Mentors Group, São Paulo, SP, Brazil. andremanoel.inacio@yahoo.com. 4. Orthopedic Departament, Coordenador FLS OSTEOTRATI - Hospital da Cruz Vermelha Brasileira do Paraná, Av Vicente Machado 1239 Batel, Curitiba, PR, Brazil. andremanoel.inacio@yahoo.com. 5. FLS Hospital Sancta Maggiore, São Paulo, SP, Brazil. 6. Coordenador FLS REVITA - Policlínica Osvaldo Cruz, Porto Velho, RO, Brazil. 7. Nuffield Department of Orthopedics, Rheumatology and Orthopedic Sciences, University of Oxford, Oxford, UK. 8. International Osteoporosis Foundation, Latin America office, Buenos Aires, Argentina.
Abstract
Expected number of fragility fractures in Brazil, raising the healthcare prioritization for interventions that reduce fracture risk. An FLS is dedicated to managing patient with fragility fracture to reduce risk of another fracture. We review FLSs cost-effectiveness and describe key components to effectively set up FLS in Brazil. PURPOSE: To create a guideline to show health professionals, hospital managers, and stakeholders in Brazil the importance of secondary fracture prevention and how to implement a Fracture Liaison Service. METHODS: We review the cost-effectiveness for FLSs in Brazil. We describe the key components needed to set up an effective FLS including methods for identification, investigation, treatment indication, including bone drugs, supplementation, physical activity, fall prevention, and monitoring. The staffing of FLSs, value of regional clinical networks and quality improvement are also described as a guide for healthcare professionals and decision makers in Brazil. RESULTS: An FLS is a service dedicated to identifying, assessing, recommending treatment, and monitoring patient who present with a fragility fracture reducing the risk of another fracture. FLS has been implemented in Brazil since 2012 overcoming a large geography and a complex health system. Even the limitations, restrictions, differences, and characteristics of each region, it is possible for health institutions to initiate an FLS, adapted to own available resources and meet the stages of identification, investigation, treatment, and monitoring. CONCLUSION: The peculiarity of the Brazilian healthcare system means FLS implementation needs to be tailored to local reality. However, even with limitations, any attempt to capture patients who suffer a fracture due to bone fragility is effective and reduces the risk of further fractures.
Expected number of fragility fractures in Brazil, raising the healthcare prioritization for interventions that reduce fracture risk. An FLS is dedicated to managing patient with fragility fracture to reduce risk of another fracture. We review FLSs cost-effectiveness and describe key components to effectively set up FLS in Brazil. PURPOSE: To create a guideline to show health professionals, hospital managers, and stakeholders in Brazil the importance of secondary fracture prevention and how to implement a Fracture Liaison Service. METHODS: We review the cost-effectiveness for FLSs in Brazil. We describe the key components needed to set up an effective FLS including methods for identification, investigation, treatment indication, including bone drugs, supplementation, physical activity, fall prevention, and monitoring. The staffing of FLSs, value of regional clinical networks and quality improvement are also described as a guide for healthcare professionals and decision makers in Brazil. RESULTS: An FLS is a service dedicated to identifying, assessing, recommending treatment, and monitoring patient who present with a fragility fracture reducing the risk of another fracture. FLS has been implemented in Brazil since 2012 overcoming a large geography and a complex health system. Even the limitations, restrictions, differences, and characteristics of each region, it is possible for health institutions to initiate an FLS, adapted to own available resources and meet the stages of identification, investigation, treatment, and monitoring. CONCLUSION: The peculiarity of the Brazilian healthcare system means FLS implementation needs to be tailored to local reality. However, even with limitations, any attempt to capture patients who suffer a fracture due to bone fragility is effective and reduces the risk of further fractures.
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