Improving hip fracture care in Spain: evolution of quality indicators in the Spanish National Hip Fracture Registry

Condorhuamán-Alvarado, Patricia Ysabel; Pareja‐Sierra, Teresa; Muñoz-Pascual, Angélica; Sáez-López, Pilar; Díez‐Sebastián, Jesús; Ojeda-Thies, Cristina; Gutiérrez-Misis, Alicia; Alarcón-Alarcón, Teresa; Cassinello, Concepción; Pérez‐Castrillón, José Luis; Gómez-Campelo, Paloma; Navarro-Castellanos, Laura; Otero-Puime, Ángel; González-Montalvo, J.I.

doi:10.1007/s11657-022-01084-y

Cited by 9 publications

(3 citation statements)

References 23 publications

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“… 4 Moreover, a significant percentage of these cases, between 5% and 50%, do not evolve favourably on their own and require surgery. 5 There are advantages and drawbacks to the different grafts; their therapeutic future involves the use of biocompatible alloplastic materials that have the fewest drawbacks and the most benefits for patients, favouring tissue regeneration and expediting processes. 6 …”

Section: Discussionmentioning

confidence: 99%

Assessment of rhBMP-2-loaded bovine hydroxyapatite granules in the guided bone regeneration of critical bone defect in rat mandible bone

López-Andaluz

Flores-Fraile

Javier-Borrajo

et al. 2023

Journal of Dental Sciences

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Section: Discussionmentioning

confidence: 99%

Assessment of rhBMP-2-loaded bovine hydroxyapatite granules in the guided bone regeneration of critical bone defect in rat mandible bone

López-Andaluz

Flores-Fraile

Javier-Borrajo

et al. 2023

Journal of Dental Sciences

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“…Furthermore, as national registries grow in number and size with time, they will allow to perform interesting analyses with comparisons between countries. These initiatives are also crucial to monitor the effectiveness of the existing model of care, promoting its continuous improvement, and to increase awareness among policymakers and health professionals [ 40 , 41 ]. Collaborative efforts aimed at sharing experiences of existing national registries and providing guidance to upcoming registries such as the “The Hip Fracture Registry Toolbox” are much appreciated [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Spanish National Registry of Major Osteoporotic Fractures (REFRA) seen at Fracture Liaison Services (FLS): objectives and quality standards

et al. 2022

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Summary REFRA-FLS is a new registry in Spain aimed at identifying individuals over 50 years of age with a fragility fracture. Using this registry, we found hip fracture is the most prevalent fracture. Treatment for osteoporosis was 87.7%, with 65.3% adherence. REFRA-FLS provides fundamental data in the study of fragility fractures. Purpose Fragility fractures are a growing public health concern in modern-aged societies. Fracture Liaison Services (FLS) have been shown to successfully lower rates of secondary fractures. A new registry (REFRA-FLS) has been created to monitor quality indicators of FLS units in Spain and to explore the occurrence and characteristic of fragility fractures identified by these centers. Methods We conducted a prospective cohort study based on fragility fractures recorded in the REFRA-FLS registry. Participants were individuals 50 years or above who suffered a low energy fragility fracture identified by the 10 participating FLS units during the study period. The type of FLS unit, the characteristics of the individuals at baseline, along with patient outcomes as quality indicators among those who completed 1 year of follow-up were analyzed. Results A total of 2965 patients and 3067 fragility fractures were identified, and the most frequent locations were hip (n = 1709, 55.7%) and spine (n = 492, 16.0%). A total of 43 refractures (4.5%) and 46 deaths (4.9%) were observed among 948 individuals in the follow-up analyses. Time from fracture to evaluation was less than 3 months in 76.7% of individuals. Osteoporosis treatment was prescribed in 87.7%, and adherence was 65.3% in Morisky–Green test. Conclusion Our results provide a comprehensive picture of fragility fractures identified in FLS units from Spain. Overall, quality indicators are satisfactory although a much higher use of DXA would be desirable. As the registry grows with the incorporation of new FLS units and longer follow-up, incoming analyses will provide valuable insight.

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“…The launch of national HFRs was associated not only with survival rate improvement, as shown by the British initiative [ 31 ], but also with the optimization of other quality indicators [ 32 ]. This improvement in survival was, at least partially, related to the reduction in the admission-to-surgery time window, as was also revealed by registries from other regions, like Ontario [ 33 ] and Denmark [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Alliance for the development of the Argentinian Hip Fracture Registry

Monteverde

Diehl²,

Saieg³

et al. 2022

Arch Osteoporos

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Summary Age expectancy has significantly increased over the last 50 years, as well as some age-related health conditions such as hip fractures. The development of hip fracture registries has shown enhanced patient outcomes through quality improvement strategies. The development of the Argentinian Hip Fracture Registry is going in the same direction. Introduction Age expectancy has increased worldwide in the last 50 years, with the population over 64 growing from 4.9 to 9.1%. As fractures are an important problem in this age group, specific approaches such as hip fracture registries (HFR) are needed. Our aim is to communicate the Argentinian HFR (AHFR) development resulting from an alliance between Fundación Trauma, Fundación Navarro Viola, and the Argentinian Network of Hip Fracture in the elderly. Methods Between October 2020 and May 2021, an iterative consensus process involving 5 specialty-focused meetings and 8 general meetings with more than 20 specialists was conducted. This process comprised inclusion criteria definitions, dataset proposals, website deployment with data protection and user validation, the definition of hospital-adjusted registry levels, implementation planning, and sustainability strategies. Results By June 2021, we were able to (1) outline data fields, including epidemiological, clinical, and functional dimensions for the pre-admission, hospitalization, discharge, and follow-up stages; (2) define three levels: basic (53 fields), intermediate (85), and advanced (99); (3) identify 21 benchmarking indicators; and (4) make a correlation scheme among fracture classifications. Simultaneously, we launched a fundraising campaign to implement the AHFR in 30 centers, having completed 18. Conclusion AHFR development was based on four pillars: (1) representativeness and support, (2) solid definitions from onset, (3) committed teams, and (4) stable funding. This tool may contribute to the design of evidence-based health policies to improve patient outcomes, and we hope this experience will help other LMICs to develop their own tailored-to-their-needs registries.

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Improving hip fracture care in Spain: evolution of quality indicators in the Spanish National Hip Fracture Registry

Cited by 9 publications

References 23 publications

Assessment of rhBMP-2-loaded bovine hydroxyapatite granules in the guided bone regeneration of critical bone defect in rat mandible bone

Assessment of rhBMP-2-loaded bovine hydroxyapatite granules in the guided bone regeneration of critical bone defect in rat mandible bone

Spanish National Registry of Major Osteoporotic Fractures (REFRA) seen at Fracture Liaison Services (FLS): objectives and quality standards

Alliance for the development of the Argentinian Hip Fracture Registry

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