Post-fracture care program in Egypt: merging subsequent fracture prevention and improving patients’ outcomes—an initiative by the Egyptian Academy of Bone Health

Abstract

Background Despite the associated high prevalence of morbidity and mortality, osteoporotic fragility fractures remain underdiagnosed and undertreated. Furthermore, those who sustain a fragility fracture are at imminent risk of sustaining subsequent fractures. Post-fracture care (PFC) programs are systematic, coordinated care programs that recognize, evaluate, and manage older adults who sustained a fragility fracture with the goal of managing all the risk factors and preventing succeeding fractures. Main text This work was carried out to outline the PFC program adopted in Egypt and its applicability in standard clinical practice. A review of literature was conducted to identify an evidence-informed PFC strategies and protocols, which outlines the optimal manner to manage older adults living with fragility fractures. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist was used to guide the reporting of this review. Based on this, a PFC integrated model of care based on a patient-centered approach has been developed aiming to optimize the outcomes. Conclusion This manuscript described the integrated model of care adopted in Egypt to provide care for older adults presenting with fragility fractures. This will pave the way to standardize patient identification and management. Additionally, to prevent occurrence of subsequent fractures and to enhance equity of care for patients with fragility fracture and osteoporosis, expansion of such service to rural and remote areas is highly recommended.

One musculoskeletal health: towards optimizing musculoskeletal health in Egypt—how to be a bone and muscle builder by the Egyptian Academy of Bone Health and Metabolic Bone Diseases

“…Fourteen centers recognized the International Osteoporosis Foundation (IOF) are functioning in Egypt covering 70% of the population. The Academy has published its clinical standards for Fracture Liaison Services [106] which has proved to be effective in both individual morbidity and mortality as well as cost [107]. Economic evaluation of osteoporosis liaison service for secondary fracture prevention in osteoporotic older adults with previous hip fracture in Egypt was reported to be cost-effective [108].…”

“…The Academy has published its clinical standards for Fracture Liaison Services [106] which has proved to be effective in both individual morbidity and mortality as well as cost [107]. Economic evaluation of osteoporosis liaison service for secondary fracture prevention in osteoporotic older adults with previous hip fracture in Egypt was reported to be cost-effective [108]. Patient and health care professional education, social media, and community activities help to increase awareness among the Egyptian population health care providers facilitating the early identification of those at high risk of fracture.…”

“…The academy had also developed the first integrated program for post-fracture care in Egypt which involved assessment of fracture probability, fall risk, sarcopenia, and quality of life alongside with prescription of the proper anti-osteoporotic medications and rehabilitation program with scheduled monitoring of the patient to ensure the medication adherence, any medication side effects, physical activity, and imminent fractures if any [109].…”