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01-12-2019 | Osteoporosis | Original Article

Breaking the cycle of recurrent fracture: implementing the first fracture liaison service (FLS) in British Columbia, Canada

Authors: Sonia Singh, David GT Whitehurst, Larry Funnell, Vicky Scott, Valerie MacDonald, Pet-Ming Leung, Kathleen Friesen, Fabio Feldman

Published in: Archives of Osteoporosis | Issue 1/2019

Abstract

Summary

Fractures occurring with very little trauma are often caused by osteoporosis and can lead to disability. This study demonstrates that a coordinator working with an orthopaedic team can significantly increase the number of individuals receiving appropriate treatments during their after-fracture care to prevent future fractures from occurring.

Purpose

Well-implemented Fracture Liaison Service (FLS) programs increase appropriate investigation and treatment for osteoporosis after low trauma fracture. This research evaluates the effectiveness of the first FLS program implemented in British Columbia (BC), Canada.

Methods

A controlled before-and-after study was conducted. The intervention was an FLS program implemented at an orthopaedic outpatient clinic at Peace Arch Hospital in BC. Eligible patients were those over the age of 50 years with a low trauma fracture of the hip, pelvis, vertebra, wrist or humerus. A nurse practitioner FLS coordinator identified, investigated and initiated treatment in patients based on their future fracture risk. The primary outcome was the percentage of all patients at high-risk to refracture, who achieved at least one of the following outcomes: (1) started on osteoporosis medication, (2) referred to an osteoporosis consultant or (3) assessed for treatment change if they were already on osteoporosis medication at the time of the fracture. Secondary outcomes included the rate of bone density testing, referral to fall prevention programs and change in health-related quality of life over 6 months.

Results

A total of 195 patients participated in the study (65 in the usual care group, 130 in the FLS group). Average age was 70.5 years (standard deviation 11.5), and 84% of participants were female. In the FLS group, 77.8% of high-risk patients achieved the primary outcome compared with 22.9% in the usual care group.

Conclusion

In BC, the implementation of an FLS program improved investigation and treatment for osteoporosis after low trauma fracture.

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Title: Breaking the cycle of recurrent fracture: implementing the first fracture liaison service (FLS) in British Columbia, Canada
Authors: Sonia Singh
David GT Whitehurst
Larry Funnell
Vicky Scott
Valerie MacDonald
Pet-Ming Leung
Kathleen Friesen
Fabio Feldman
Publication date: 01-12-2019
Publisher: Springer London
Keywords: Osteoporosis
Osteoporosis
Published in: Archives of Osteoporosis / Issue 1/2019
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-019-0662-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Breaking the cycle of recurrent fracture: implementing the first fracture liaison service (FLS) in British Columbia, Canada

Abstract

Summary

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusion

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