Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Archives of Osteoporosis
Published in: Archives of Osteoporosis 1/2023

Open Access 01-12-2023 | Care | Review Article

The integrated structure of care: evidence for the efficacy of models of clinical governance in the prevention of fragility fractures after recent sentinel fracture after the age of 50 years

Authors: L. Cianferotti, G. Porcu, R. Ronco, G. Adami, R. Alvaro, R. Bogini, A. P. Caputi, B. Frediani, D. Gatti, S. Gonnelli, G. Iolascon, A. Lenzi, S. Leone, R. Michieli, S. Migliaccio, T. Nicoletti, M. Paoletta, A. Pennini, E. Piccirilli, M. Rossini, U. Tarantino, M. L. Brandi, G. Corrao, A. Biffi

Published in: Archives of Osteoporosis | Issue 1/2023

Login to get access

Abstract

Summary

Randomized clinical trials and observational studies on the implementation of clinical governance models, in patients who had experienced a fragility fracture, were examined. Literature was systematically reviewed and summarized by a panel of experts who formulated recommendations for the Italian guideline.

Purpose

After experiencing a fracture, several strategies may be adopted to reduce the risk of recurrent fragility fractures and associated morbidity and mortality. Clinical governance models, such as the fracture liaison service (FLS), have been introduced for the identification, treatment, and monitoring of patients with secondary fragility fractures. A systematic review was conducted to evaluate the association between multidisciplinary care systems and several outcomes in patients with a fragility fracture in the context of the development of the Italian Guidelines.

Methods

PubMed, Embase, and the Cochrane Library were investigated up to December 2020 to update the search of the Scottish Intercollegiate Guidelines Network. Randomized clinical trials (RCTs) and observational studies that analyzed clinical governance models in patients who had experienced a fragility fracture were eligible. Three authors independently extracted data and appraised the risk of bias in the included studies. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Effect sizes were pooled in a meta-analysis using random-effects models. Primary outcomes were bone mineral density values, antiosteoporotic therapy initiation, adherence to antiosteoporotic medications, subsequent fracture, and mortality risk, while secondary outcomes were quality of life and physical performance.

Results

Fifteen RCTs and 62 observational studies, ranging from very low to low quality for bone mineral density values, antiosteoporotic initiation, adherence to antiosteoporotic medications, subsequent fracture, mortality, met our inclusion criteria. The implementation of clinical governance models compared to their pre-implementation or standard care/non-attenders significantly improved BMD testing rate, and increased the number of patients who initiated antiosteoporotic therapy and enhanced their adherence to the medications. Moreover, the treatment by clinical governance model respect to standard care/non-attenders significantly reduced the risk of subsequent fracture and mortality. The integrated structure of care enhanced the quality of life and physical function among patients with fragility fractures.

Conclusions

Based on our findings, clinicians should promote the management of patients experiencing a fragility fracture through structured and integrated models of care. The task force has formulated appropriate recommendations on the implementation of multidisciplinary care systems in patients with, or at risk of, fragility fractures.
Appendix
Available only for authorised users
Literature
1.
Borgström F, Karlsson L, Ortsäter G, Norton N, Halbout P, Cooper C et al (2020) Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos 15:59PubMedPubMedCentral
2.
Compston JE, McClung MR, Leslie WD (2019) Osteoporosis. Lancet 393:364–376PubMed
3.
Wong RMY, Wong PY, Liu C, Wong HW, Chung YL, Chow SKH et al (2022) The imminent risk of a fracture-existing worldwide data: a systematic review and meta-analysis. Osteoporos Int 33(12):2453–2466PubMed
4.
Kanis JA, Cooper C, Rizzoli R, Reginster JY (2019) Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 30:3–44PubMed
5.
6.
Curtis EM, Dennison EM, Cooper C, Harvey NC. Osteoporosis in 2022: care gaps to screening and personalised medicine. Best Pract Res Clin Rheumatol 2022;101754.
7.
Mitchell PJ, Cooper C, Fujita M, Halbout P, Åkesson K, Costa M et al (2019) Quality improvement initiatives in fragility fracture care and prevention. Curr Osteoporos Rep 17:510–520PubMed
8.
Geusens P, Bours SPG, Wyers CE, van den Bergh JP (2019) Fracture liaison programs. Best Pract Res Clin Rheumatol 33:278–289PubMed
9.
Javaid MK (2021) Efficacy and efficiency of fracture liaison services to reduce the risk of recurrent osteoporotic fractures. Aging Clin Exp Res 33:2061–2067PubMedPubMedCentral
10.
Lewiecki EM, Ortendahl JD, Vanderpuye-Orgle J, Grauer A, Arellano J, Lemay J et al (2019) Healthcare policy changes in osteoporosis can improve outcomes and reduce costs in the United States. JBMR Plus 3:e10192PubMedPubMedCentral
11.
Schünemann HJ, Wiercioch W, Brozek J, Etxeandia-Ikobaltzeta I, Mustafa RA, Manja V et al (2017) GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT. J Clin Epidemiol 81:101–110PubMed
12.
13.
Scottish Intercollegiate Guidelines Network (2015) Management of osteoporosis and the prevention of fragility fractures: a national clinical guideline. Scottish Intercollegiate Guidelines Network
14.
Page MJ, Moher D (2017) Evaluations of the uptake and impact of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement and extensions: a scoping review. Syst Rev 6:263PubMedPubMedCentral
15.
Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J et al (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 358:j4008PubMedPubMedCentral
16.
Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928PubMedPubMedCentral
17.
Stang A (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605PubMed
18.
Balshem H, Helfand M, Schünemann HJ, Oxman AD, Kunz R, Brozek J et al (2011) GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol 64:401–406PubMed
19.
20.
21.
DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188PubMed
22.
Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634PubMedPubMedCentral
23.
Lamb LC, Montgomery SC, Wong Won B, Harder S, Meter J, Feeney JM (2017) A multidisciplinary approach to improve the quality of care for patients with fragility fractures. J Orthop 14:247–251PubMedPubMedCentral
24.
Brañas F, Ruiz-Pinto A, Fernández E, Del Cerro A, de Dios R, Fuentetaja L et al (2018) Beyond orthogeriatric co-management model: benefits of implementing a process management system for hip fracture. Arch Osteoporos 13:81PubMed
25.
Singh S, Whitehurst DG, Funnell L, Scott V, MacDonald V, Leung PM et al (2019) Breaking the cycle of recurrent fracture: implementing the first fracture liaison service (FLS) in British Columbia, Canada. Arch Osteoporos 14:116PubMed
26.
Sofie S, Yves P, Barbara V, Margareta L, Raf VH, Bruno V et al (2018) Building for better bones: evaluation of a clinical pathway in the secondary prevention of osteoporotic fractures. Eur J Hosp Pharm 25:210–213PubMed
27.
Coventry LS, Nguyen A, Karahalios A, Roshan-Zamir S, Tran P (2017) Comparison of 3 different perioperative care models for patients with hip fractures within 1 health service. Geriatr Orthop Surg Rehabil 8:87–93PubMedPubMedCentral
28.
Majumdar SR, McAlister FA, Johnson JA, Rowe BH, Bellerose D, Hassan I et al (2018) Comparing strategies targeting osteoporosis to prevent fractures after an upper extremity fracture (C-STOP Trial): a randomized controlled trial. J Bone Miner Res 33:2114–2121PubMed
29.
Wasfie T, Jackson A, Brock C, Galovska S, McCullough JR, Burgess JA (2019) Does a fracture liaison service program minimize recurrent fragility fractures in the elderly with osteoporotic vertebral compression fractures? Am J Surg 217:557–560PubMed
30.
Bachour F, Rizkallah M, Sebaaly A, Barakat A, Razzouk H, El Hage R et al (2017) Fracture liaison service: report on the first successful experience from the Middle East. Arch Osteoporos 12:79PubMed
31.
Anighoro K, Bridges C, Graf A, Nielsen A, Court T, McKeon J et al (2020) From ER to OR: results after implementation of multidisciplinary pathway for fragility hip fractures at a level I trauma center. Geriatr Orthop Surg Rehabil 11:2151459320927383PubMedPubMedCentral
32.
Anderson ME, Mcdevitt K, Cumbler E, Bennett H, Robison Z, Gomez B et al (2017) Geriatric hip fracture care: fixing a fragmented system. Perm J 21:16–104PubMedPubMedCentral
33.
Aubry-Rozier B, Stoll D, Gonzalez Rodriguez E, Hans D, Prudent V, Seuret A et al (2018) Impact of a fracture liaison service on patient management after an osteoporotic fracture: the CHUV FLS. Swiss Med Wkly 148:w14579PubMed
34.
Soong C, Cram P, Chezar K, Tajammal F, Exconde K, Matelski J et al (2016) Impact of an integrated hip fracture inpatient program on length of stay and costs. J Orthop Trauma 30:647–652PubMed
35.
Beaupre LA, Moradi F, Khong H, Smith C, Evens L, Hanson HM et al (2020) Implementation of an in-patient hip fracture liaison services to improve initiation of osteoporosis medication use within 1-year of hip fracture: a population-based time series analysis using the RE-AIM framework. Arch Osteoporos 15:83PubMed
36.
Inderjeeth CA, Raymond WD, Briggs AM, Geelhoed E, Oldham D, Mountain D (2018) Implementation of the Western Australian Osteoporosis Model of Care: a fracture liaison service utilising emergency department information systems to identify patients with fragility fracture to improve current practice and reduce re-fracture rates: a 12-month analysis. Osteoporos Int 29:1759–1770PubMed
37.
Greenspan SL, Singer A, Vujevich K, Marchand B, Thompson DA, Hsu YJ et al (2018) Implementing a fracture liaison service open model of care utilizing a cloud-based tool. Osteoporos Int 29:953–960PubMedPubMedCentral
38.
Beaton DE, Mamdani M, Zheng H, Jaglal S, Cadarette SM, Bogoch ER et al (2017) Improvements in osteoporosis testing and care are found following the wide scale implementation of the Ontario Fracture Clinic Screening Program: an interrupted time series analysis. Medicine (Baltimore) 96:e9012PubMed
39.
Chan T, de Lusignan S, Cooper A, Elliott M (2015) Improving osteoporosis management in primary care: an audit of the impact of a community based fracture liaison nurse. PLoS One 10:e0132146PubMedPubMedCentral
40.
Schuijt HJ, Kusen J, van Hernen JJ, van der Vet P, Geraghty O, Smeeing DPJ et al (2020) Orthogeriatric trauma unit improves patient outcomes in geriatric hip fracture patients. Geriatr Orthop Surg Rehabil 11:2151459320949476PubMedPubMedCentral
41.
Rotman-Pikielny P, Frankel M, Lebanon OT, Yaacobi E, Tamar M, Netzer D et al (2018) Orthopedic-metabolic collaborative management for osteoporotic hip fracture. Endocr Pract 24:718–725PubMed
42.
Naranjo A, Fernández-Conde S, Ojeda S, Torres-Hernández L, Hernández-Carballo C, Bernardos I et al (2017) Preventing future fractures: effectiveness of an orthogeriatric fracture liaison service compared to an outpatient fracture liaison service and the standard management in patients with hip fracture. Arch Osteoporos 12:112PubMed
43.
Davidson E, Seal A, Doyle Z, Fielding K, McGirr J (2017) Prevention of osteoporotic refractures in regional Australia. Aust J Rural Health 25:362–368PubMed
44.
Svenøy S, Watne LO, Hestnes I, Westberg M, Madsen JE, Frihagen F (2020) Results after introduction of a hip fracture care pathway: comparison with usual care. Acta Orthop 91:139–145PubMedPubMedCentral
45.
Vaculík J, Stepan JJ, Dungl P, Majerníček M, Čelko A, Džupa V (2017) Secondary fracture prevention in hip fracture patients requires cooperation from general practitioners. Arch Osteoporos 12:49PubMed
46.
Sietsema DL, Araujo AB, Wang L, Boytsov NN, Pandya SA, Haynes VS et al (2018) The effectiveness of a private orthopaedic practice-based osteoporosis management service to reduce the risk of subsequent fractures. J Bone Joint Surg Am 100:1819–1828PubMed
47.
Amphansap T, Stitkitti N, Arirachakaran A (2020) The effectiveness of Police General Hospital’s fracture liaison service (PGH’s FLS) implementation after 5 years: a prospective cohort study. Osteoporos Sarcopenia 6:199–204PubMedPubMedCentral
48.
Abrahamsen C, Nørgaard B, Draborg E, Nielsen MF (2019) The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study. BMC Geriatr 19:268PubMedPubMedCentral
49.
Baroni M, Serra R, Boccardi V, Ercolani S, Zengarini E, Casucci P et al (2019) The orthogeriatric comanagement improves clinical outcomes of hip fracture in older adults. Osteoporos Int 30:907–916PubMed
50.
Sanli I, van Helden SH, Ten Broeke RHM, Geusens P, Van den Bergh JPW, Brink PRG et al (2019) The role of the Fracture Liaison Service (FLS) in subsequent fracture prevention in the extreme elderly. Aging Clin Exp Res 31:1105–1111PubMed
51.
Hawley S, Javaid MK, Prieto-Alhambra D, Lippett J, Sheard S, Arden NK et al (2016) Clinical effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: population-based longitudinal study. Age Ageing 45:236–242PubMedPubMedCentral
52.
Shigemoto K, Sawaguchi T, Goshima K, Iwai S, Nakanishi A, Ueoka K (2019) The effect of a multidisciplinary approach on geriatric hip fractures in Japan. J Orthop Sci 24:280–285PubMed
53.
Ganda K, Puech M, Chen JS, Speerin R, Bleasel J, Center JR et al (2013) Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int 24:393–406PubMed
54.
Bell K, Strand H, Inder WJ (2014) Effect of a dedicated osteoporosis health professional on screening and treatment in outpatients presenting with acute low trauma non-hip fracture: a systematic review. Arch Osteoporos 9:167PubMed
55.
Chang YF, Huang CF, Hwang JS, Kuo JF, Lin KM, Huang HC et al (2018) Fracture liaison services for osteoporosis in the Asia-Pacific region: current unmet needs and systematic literature review. Osteoporos Int 29:779–792PubMed
56.
Wu CH, Chen CH, Chen PH, Yang JJ, Chang PC, Huang TC et al (2018) Identifying characteristics of an effective fracture liaison service: systematic literature review. Osteoporos Int 29:1023–1047PubMed
57.
Wu CH, Tu ST, Chang YF, Chan DC, Chien JT, Lin CH et al (2018) Fracture liaison services improve outcomes of patients with osteoporosis-related fractures: a systematic literature review and meta-analysis. Bone 111:92–100PubMed
58.
Talevski J, Sanders KM, Duque G, Connaughton C, Beauchamp A, Green D et al (2019) Effect of clinical care pathways on quality of life and physical function after fragility fracture: a meta-analysis. J Am Med Dir Assoc 20:926.e1–926.e11PubMed
59.
Laslett LL, Whitham JN, Gibb C, Gill TK, Pink JA, McNeil JD (2007) Improving diagnosis and treatment of osteoporosis: evaluation of a clinical pathway for low trauma fractures. Arch Osteoporos 2:1–6PubMedCentral
60.
Davis JC, Guy P, Ashe MC, Liu-Ambrose T, Khan K (2007) HipWatch: osteoporosis investigation and treatment after a hip fracture: a 6-month randomized controlled trial. J Gerontol A Biol Sci Med Sci 62:888–891PubMed
61.
Cranney A, Lam M, Ruhland L, Brison R, Godwin M, Harrison MM et al (2008) A multifaceted intervention to improve treatment of osteoporosis in postmenopausal women with wrist fractures: a cluster randomized trial. Osteoporos Int 19:1733–1740PubMed
62.
Majumdar SR, Johnson JA, McAlister FA, Bellerose D, Russell AS, Hanley DA et al (2008) Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial. CMAJ 178:569–575PubMedPubMedCentral
63.
Morrish DW, Beaupre LA, Bell NR, Cinats JG, Hanley DA, Harley CH et al (2009) Facilitated bone mineral density testing versus hospital-based case management to improve osteoporosis treatment for hip fracture patients: additional results from a randomized trial. Arthritis Rheum 61:209–215PubMed
64.
Yuksel N, Majumdar SR, Biggs C, Tsuyuki RT (2010) Community pharmacist-initiated screening program for osteoporosis: randomized controlled trial. Osteoporos Int 21:391–398PubMed
65.
Leslie WD, LaBine L, Klassen P, Dreilich D, Caetano PA (2012) Closing the gap in postfracture care at the population level: a randomized controlled trial. CMAJ 184:290–296PubMedPubMedCentral
66.
Roux S, Beaulieu M, Beaulieu MC, Cabana F, Boire G (2013) Priming primary care physicians to treat osteoporosis after a fragility fracture: an integrated multidisciplinary approach. J Rheumatol 40:703–711PubMed
67.
Hawker G, Ridout R, Ricupero M, Jaglal S, Bogoch E (2003) The impact of a simple fracture clinic intervention in improving the diagnosis and treatment of osteoporosis in fragility fracture patients. Osteoporos Int 14:171–178PubMed
68.
Majumdar SR, Rowe BH, Folk D, Johnson JA, Holroyd BH, Morrish DW et al (2004) A controlled trial to increase detection and treatment of osteoporosis in older patients with a wrist fracture. Ann Intern Med 141:366–373PubMed
69.
Jaglal SB, Hawker G, Bansod V, Salbach NM, Zwarenstein M, Carroll J et al (2009) A demonstration project of a multi-component educational intervention to improve integrated post-fracture osteoporosis care in five rural communities in Ontario. Canada. Osteoporos Int 20:265–274PubMed
70.
Beaton DE, Vidmar M, Pitzul KB, Sujic R, Rotondi NK, Bogoch ER et al (2017) Addition of a fracture risk assessment to a coordinator’s role improved treatment rates within 6 months of screening in a fragility fracture screening program. Osteoporos Int 28:863–869PubMed
71.
Amphansap T, Stitkitti N, Dumrongwanich P (2016) Evaluation of Police General Hospital’s Fracture Liaison Service (PGH’s FLS): the first study of a Fracture Liaison Service in Thailand. Osteoporos Sarcopenia 2:238–243PubMedPubMedCentral
72.
Queally JM, Kiernan C, Shaikh M, Rowan F, Bennett D (2013) Initiation of osteoporosis assessment in the fracture clinic results in improved osteoporosis management: a randomised controlled trial. Osteoporos Int 24:1089–1094PubMed
73.
Brankin E, Mitchell C, Munro R, Lanarkshire Osteoporosis Service (2005) Closing the osteoporosis management gap in primary care: a secondary prevention of fracture programme. Curr Med Res Opin 21:475–482
74.
Murray AW, McQuillan C, Kennon B, Gallacher SJ (2005) Osteoporosis risk assessment and treatment intervention after hip or shoulder fracture. A comparison of two centres in the United Kingdom. Injury 36:1080–1084PubMed
75.
Wallace I, Callachand F, Elliott J, Gardiner P (2011) An evaluation of an enhanced fracture liaison service as the optimal model for secondary prevention of osteoporosis. JRSM Short Rep 2:8PubMedPubMedCentral
76.
Ruggiero C, Zampi E, Rinonapoli G, Baroni M, Serra R, Zengarini E et al (2015) Fracture prevention service to bridge the osteoporosis care gap. Clin Interv Aging 10:1035–1042PubMedPubMedCentral
77.
Miki RA, Oetgen ME, Kirk J, Insogna KL, Lindskog DM (2008) Orthopaedic management improves the rate of early osteoporosis treatment after hip fracture. A randomized clinical trial. J Bone Joint Surg Am 90:2346–2353PubMed
78.
Kamel HK, Hussain MS, Tariq S, Perry HM, Morley JE (2000) Failure to diagnose and treat osteoporosis in elderly patients hospitalized with hip fracture. Am J Med 109:326–328PubMed
79.
Harrington JT, Barash HL, Day S, Lease J (2005) Redesigning the care of fragility fracture patients to improve osteoporosis management: a health care improvement project. Arthritis Rheum 53:198–204PubMed
80.
Johnson SL, Petkov VI, Williams MI, Via PS, Adler RA (2005) Improving osteoporosis management in patients with fractures. Osteoporos Int 16:1079–1085PubMed
81.
Streeten EA, Mohamed A, Gandhi A, Orwig D, Sack P, Sterling R et al (2006) The inpatient consultation approach to osteoporosis treatment in patients with a fracture. Is automatic consultation needed? J Bone Joint Surg Am 88:1968–1974PubMed
82.
Tosi LL, Gliklich R, Kannan K, Koval KJ (2008) The American Orthopaedic Association’s “own the bone” initiative to prevent secondary fractures. J Bone Joint Surg Am 90:163–173PubMed
83.
Roy A, Heckman MG, O’Connor MI (2011) Optimizing screening for osteoporosis in patients with fragility hip fracture. Clin Orthop Relat Res 469:1925–1930PubMedPubMedCentral
84.
Heilmann RMF, Friesleben CR, Billups SJ (2012) Impact of a pharmacist-directed intervention in postmenopausal women after fracture. Am J Health Syst Pharm 69:504–509PubMed
85.
Hofflich HL, Oh DK, Choe CH, Clay B, Tibble C, Kulasa KM et al (2014) Using a triggered endocrinology service consultation to improve the evaluation, management, and follow-up of osteoporosis in hip-fracture patients. Jt Comm J Qual Patient Saf 40:228–234PubMed
86.
Cosman F, Nicpon K, Nieves JW (2017) Results of a fracture liaison service on hip fracture patients in an open healthcare system. Aging Clin Exp Res 29:331–334PubMed
87.
Jones G, Warr S, Francis E, Greenaway T (2005) The effect of a fracture protocol on hospital prescriptions after minimal trauma fractured neck of the femur: a retrospective audit. Osteoporos Int 16:1277–1280PubMed
88.
Fisher AA, Davis MW, Rubenach SE, Sivakumaran S, Smith PN, Budge MM (2006) Outcomes for older patients with hip fractures: the impact of orthopedic and geriatric medicine cocare. J Orthop Trauma 20:172–8; discussion 179-180PubMed
89.
Lih A, Nandapalan H, Kim M, Yap C, Lee P, Ganda K et al (2011) Targeted intervention reduces refracture rates in patients with incident non-vertebral osteoporotic fractures: a 4-year prospective controlled study. Osteoporos Int 22:849–858PubMed
90.
Van der Kallen J, Giles M, Cooper K, Gill K, Parker V, Tembo A et al (2014) A fracture prevention service reduces further fractures two years after incident minimal trauma fracture. Int J Rheum Dis 17:195–203PubMed
91.
Astrand J, Nilsson J, Thorngren KG (2012) Screening for osteoporosis reduced new fracture incidence by almost half: a 6-year follow-up of 592 fracture patients from an osteoporosis screening program. Acta Orthop 83:661–665PubMedPubMedCentral
92.
Rolnick SJ, Kopher R, Jackson J, Fischer LR, Compo R (2001) What is the impact of osteoporosis education and bone mineral density testing for postmenopausal women in a managed care setting? Menopause 8:141–148PubMed
93.
Jachna CM, Whittle J, Lukert B, Graves L, Bhargava T (2003) Effect of hospitalist consultation on treatment of osteoporosis in hip fracture patients. Osteoporos Int 14:665–671PubMed
94.
Ganda K, Schaffer A, Pearson S, Seibel MJ (2014) Compliance and persistence to oral bisphosphonate therapy following initiation within a secondary fracture prevention program: a randomised controlled trial of specialist vs. non-specialist management. Osteoporos Int 25:1345–1355PubMed
95.
Nakayama A, Major G, Holliday E, Attia J, Bogduk N (2016) Evidence of effectiveness of a fracture liaison service to reduce the re-fracture rate. Osteoporos Int 27:873–879PubMed
96.
Goltz L, Degenhardt G, Maywald U, Kirch W, Schindler C (2013) Evaluation of a program of integrated care to reduce recurrent osteoporotic fractures. Pharmacoepidemiol Drug Saf 22:263–270PubMed
97.
Huntjens KMB, van Geel TCM, Geusens PP, Winkens B, Willems P, van den Bergh J et al (2011) Impact of guideline implementation by a fracture nurse on subsequent fractures and mortality in patients presenting with non-vertebral fractures. Injury 42(Suppl 4):S39–S43PubMed
98.
Huntjens KMB, van Geel TACM, van den Bergh JPW, van Helden S, Willems P, Winkens B et al (2014) Fracture liaison service: impact on subsequent nonvertebral fracture incidence and mortality. J Bone Joint Surg Am 96:e29PubMed
99.
Henderson CY, Shanahan E, Butler A, Lenehan B, O’Connor M, Lyons D et al (2017) Dedicated orthogeriatric service reduces hip fracture mortality. Ir J Med Sci 186:179–184PubMed
100.
Vidán M, Serra JA, Moreno C, Riquelme G, Ortiz J (2005) Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial. J Am Geriatr Soc 53:1476–1482PubMed
101.
Axelsson KF, Jacobsson R, Lund D, Lorentzon M (2016) Effectiveness of a minimal resource fracture liaison service. Osteoporos Int 27:3165–3175PubMedPubMedCentral
102.
Majumdar SR, Johnson JA, Bellerose D, McAlister FA, Russell AS, Hanley DA et al (2011) Nurse case-manager vs multifaceted intervention to improve quality of osteoporosis care after wrist fracture: randomized controlled pilot study. Osteoporos Int 22:223–230PubMed
103.
van Helden S, Cauberg E, Geusens P, Winkes B, van der Weijden T, Brink P (2007) The fracture and osteoporosis outpatient clinic: an effective strategy for improving implementation of an osteoporosis guideline. J Eval Clin Pract 13:801–805PubMed
104.
Sidwell AI, Wilkinson TJ, Hanger HC (2004) Secondary prevention of fractures in older people: evaluation of a protocol for the investigation and treatment of osteoporosis. Intern Med J 34:129–132PubMed
105.
Merle B, Chapurlat R, Vignot E, Thomas T, Haesebaert J, Schott AM (2017) Post-fracture care: do we need to educate patients rather than doctors? The PREVOST randomized controlled trial. Osteoporos Int 28:1549–1558PubMed
106.
Sistema Nazionale Linee Guida (2021). Diagnosi, Stratificazione del rischio e continuità assistenziale delle Fratture da Fragilità. https://​snlg.​iss.​it/​. Accessed 20 Dec 2022
107.
Li N, Hiligsmann M, Boonen A, van Oostwaard MM, de Bot RTAL, Wyers CE et al (2021) The impact of fracture liaison services on subsequent fractures and mortality: a systematic literature review and meta-analysis. Osteoporos Int 32:1517–1530PubMedPubMedCentral
108.
Åkesson KE, Ganda K, Deignan C, Oates MK, Volpert A, Brooks K et al (2022) Post-fracture care programs for prevention of subsequent fragility fractures: a literature assessment of current trends. Osteoporos Int 33(8):1659–1676PubMedPubMedCentral
109.
Javaid MK, Sami A, Lems W, Mitchell P, Thomas T, Singer A et al (2020) A patient-level key performance indicator set to measure the effectiveness of fracture liaison services and guide quality improvement: a position paper of the IOF Capture the Fracture Working Group, National Osteoporosis Foundation and Fragility Fracture Network. Osteoporos Int 31:1193–1204PubMedPubMedCentral
110.
Eisman JA, Bogoch ER, Dell R, Harrington JT, McKinney RE, McLellan A et al (2012) Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res 27:2039–2046PubMed
111.
Lems WF, Dreinhöfer KE, Bischoff-Ferrari H, Blauth M, Czerwinski E, da Silva J et al (2017) EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures. Ann Rheum Dis 76:802–810PubMed
112.
Kanis JA, Cooper C, Rizzoli R, Reginster JY (2019) Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). Executive summary of European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Aging Clin Exp Res 31:15–17PubMed
113.
Kanis JA, Cooper C, Rizzoli R, Abrahamsen B, Al-Daghri NM, Brandi ML et al (2017) Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int 28:2023–2034PubMedPubMedCentral
114.
Anderson PA, Freedman BA, Brox WT, Shaffer WO (2021) Osteoporosis: recent recommendations and positions of the American Society for Bone and Mineral Research and the International Society for Clinical Densitometry. J Bone Joint Surg Am 103:741–747PubMed
115.
Shoback D, Rosen CJ, Black DM, Cheung AM, Murad MH, Eastell R (2020) Pharmacological Management of Osteoporosis in Postmenopausal Women: an Endocrine Society Guideline update. J Clin Endocrinol Metab 105:dgaa048PubMed
116.
Arceo-Mendoza RM, Camacho PM (2021) Postmenopausal osteoporosis: latest guidelines. Endocrinol Metab Clin North Am 50:167–178PubMed
117.
Akesson K, Marsh D, Mitchell PJ, McLellan AR, Stenmark J, Pierroz DD et al (2013) Capture the Fracture: a Best Practice Framework and global campaign to break the fragility fracture cycle. Osteoporos Int 24:2135–2152PubMedPubMedCentral
118.
119.
120.
121.
122.
123.
Metadata
Title
The integrated structure of care: evidence for the efficacy of models of clinical governance in the prevention of fragility fractures after recent sentinel fracture after the age of 50 years
Authors
L. Cianferotti
G. Porcu
R. Ronco
G. Adami
R. Alvaro
R. Bogini
A. P. Caputi
B. Frediani
D. Gatti
S. Gonnelli
G. Iolascon
A. Lenzi
S. Leone
R. Michieli
S. Migliaccio
T. Nicoletti
M. Paoletta
A. Pennini
E. Piccirilli
M. Rossini
U. Tarantino
M. L. Brandi
G. Corrao
A. Biffi
Publication date
01-12-2023
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2023
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-023-01316-9

Other articles of this Issue 1/2023

Archives of Osteoporosis 1/2023 Go to the issue

Original Article

GRADE-ADOLOPMENT of clinical practice guideline for postmenopausal osteoporosis management—a Pakistani context

Original Article

Adoption of telemedicine care for osteoporotic patients during the COVID-19 pandemic: experience from a tertiary care center in Saudi Arabia

Original Article

Spinal medial branch nerve root block (MBNB) intervention compared to standard care-vertebroplasty (VP) for the treatment of painful osteoporotic vertebral fractures in frail, older hospitalised patients: a feasibility study

Original Article

Assessment of osteoporosis knowledge, awareness, and risk factors among premenopausal and postmenopausal women from Jordan: a cross-sectional study

Original Article

The relationship between obesity and bone mineral density in children and adolescents: analysis of the National Health and Nutrition Examination Survey

Original Article

Risk factors for the comorbidity of osteoporosis/osteopenia and kidney stones: a cross-sectional study