Fracture Liaison Services Showcased at IOF Regionals

The recent International Osteoporosis Foundation (IOF) Regionals 6th Asia-Pacific Osteoporosis Meeting highlighted the importance of implementing a coordinator-based Fracture Liaison Services (FLS) in clinics and hospitals.

According to the November 5, 2016 news release, “…studies have also shown that, where there is no FLS or similar service in place, approximately 80% of fragility fracture patients are neither assessed or treated for osteoporosis, the underlying cause of fractures.”

One of the studies presented was by Dr. C.-H. Chen, Department of Orthopaedics, Kaoshsiung Medical University, Taiwan. His 229 patient study of two hospitals found that the FLS was able to increase the rates of assessment and treatment, and has reduced mortality rates after fracture.

A Thai study of the FLS at the Police General Hospital, Bangkok, assessed the outcomes for hip fracture patients who participated at the hospital’s fracture service. It was found that, compared to a previous study, FLS improved the treatment rate of osteoporosis and helped to prevent secondary osteoporotic fractures.

A study from the Department of Orthopedics, National Taiwan University Hospital, Taipei City, evaluated the outcomes of a local FLS network which includes five hospitals. The FLS network was able to significantly increase the rates of bone mineral density (BMD) assessment and osteoporosis treatment.

Professor Cyrus Cooper, chairman of the Committee of Scientific Advisors of the IOF, stated, “Due to its vast and rapidly ageing populations, the Asia-Pacific region is in urgent need of effective FLS to stem the growing tide of osteoporosis-related fractures. These essential services are still rare in the Asian-Pacific and we hope that the strong FLS focus at the 6th Asia-Pacific Osteoporosis Meeting will serve to encourage the implementation of FLS more widely in hospitals throughout the region.”

Asked for details on the FLS, Professor Cooper told OTW, “An FLS is a model of patient care, with a coordinator (often a nurse) at its centre, which ensures that all fracture patients go through a systematic pathway to receive appropriate assessment, treatment and follow up. FLS are often implemented in clinics and hospitals which first respond to patients presenting with fractures. They ensure that the fracture is not simply repaired, but that the patient goes on to receive appropriate assessment, osteoporosis therapy, lifestyle advice, and fall prevention to prevent subsequent fractures.”

As for future challenges, he noted, “Studies have shown that the costs of implementing FLS result in long-term savings and considerable benefits to the patients. However, as with any investment in healthcare, authorities and hospital administrators do need to be persuaded to commit to the service and budget for its implementation and continued sustainability.”

“We encourage the orthopaedic community to champion the cause of FLS implementation in their clinics. Successful FLS have been shown to result in lower re-fracture rates, cost savings for the healthcare system and improvement in the quality of life of patients. As the healthcare professional who is a first responder and immediately involved with the fracture patient, orthopaedic surgeons play a crucial role in the identification of the fragility fracture patient, and in the successful operation of FLS services.”