The effectiveness of Police General Hospital’s fracture liaison service (PGH’s FLS) implementation after 5 years: A prospective cohort study

Amphansap, Tanawat; Stitkitti, Nitirat; Arirachakaran, Alisara

doi:10.1016/j.afos.2020.11.004

Cited by 11 publications

(26 citation statements)

References 23 publications

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“…The accuracy of our reported mortality rate was ascertained by triangulation of hospital database and verification with patients’ next of kin, limiting the possibility of underestimating the death rate. Notably, the 1-year mortality of hip fracture patients in our institution at the initiation of FLS was 10.7% [ 17 ], and was later reduced to 5.95% after 5 years of FLS implementation [ 18 ], inferring the benefit of FLS in reduction of mortality rate.…”

Section: Discussionmentioning

confidence: 99%

Mortality and outcome in fragility hip fracture care during COVID-19 pandemic in Police General Hospital, Thailand

Stitkitti

Amphansap

Therdyothin

2023

Osteoporosis and Sarcopenia

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Section: Discussionmentioning

confidence: 99%

Mortality and outcome in fragility hip fracture care during COVID-19 pandemic in Police General Hospital, Thailand

Stitkitti

Amphansap

Therdyothin

2023

Osteoporosis and Sarcopenia

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“…Some studies have reported that FLS implementation did not sufficiently prevent secondary fractures within 1 year after surgery. In contrast, Amphansap et al reported that the secondary fracture rates in FLS for patients receiving Dmab or PTH therapy were lower than those in patients without FLS implementation after a 1-year follow-up period [ 16 ]. It may be necessary to fully consider the drug selection as well the introduction of osteoporosis treatment for secondary fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have reported that FLS implementation resulted in a considerably higher proportion of patients being investigated and receiving treatment for osteoporosis following a proximal femoral fracture [ 13 , 14 ]. While patients treated with anti-osteoporotic drugs after FLS implementation had lower mortality rates compared with those managed before the implementation of the FLS [ 15 ], one report showed that FLS could not improve the 1-year mortality rates [ 16 ]. Therefore, the efficacy of postoperative osteoporosis treatment by implementing FLS might not have been fully clarified and there is little information regarding the clinical efficacy of FLS among Asian populations.…”

Section: Introductionmentioning

confidence: 99%

Secondary fracture rates and risk factors 1 year after a proximal femoral fracture under FLS

et al. 2023

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Introduction We aimed to investigate the secondary fracture rates and risk factors in patients with proximal femoral fractures using fracture liaison service (FLS) during the coronavirus disease (COVID)-19 pandemic. Materials and methods In this multi-center prospective cohort study, patients with proximal femoral fractures who were treated surgically at three hospitals from April 2020 to March 2021 were included. Follow-up examinations at 6 and 12 months postoperatively were conducted to investigate the clinical data and ascertain whether osteoporosis treatment could be continued. Results A total of 316 patients with proximal femoral fractures were registered. During the follow-up period, 17 patients died and 67 patients could not visit the hospitals owing to the COVID-19 pandemic. In total, 172 patients who could be followed-up 12 months postoperatively were examined using dual-energy X-ray absorptiometry during hospitalization; underwent postoperative osteoporosis treatment, mainly with bisphosphonates (89.5%); and were administered medications continuously. Secondary fractures occurred within 1 year in 14 patients (8.1%). Multivariate analysis showed that patients who used sleeping pills and had a lower functional independence measure had an increased risk for developing secondary fractures. Conclusion During the COVID-19 pandemic, secondary fractures can be prevented if the patients can be followed and osteoporosis treatment can be continued. Conversely, despite adequate osteoporosis drug examination and treatment, a certain number of secondary fractures still occurred. The finding that postoperative osteoporosis therapy using routine medications and rehabilitation is associated with secondary fractures may support the importance of establishing clinical standards consisting of a multidisciplinary collaboration for FLS.

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“…In 2020, Amphansap et al described the effectiveness of the Police General Hospital’s FLS after 5 years of implementation [ 108 ]. The rate of osteoporosis assessment increased from 28.3% pre-implementation to 85.8% post-FLS implementation.…”

Section: Global Regional National and Local Quality Improvement Initi...mentioning

confidence: 99%

Quality improvement initiatives in the care and prevention of fragility fractures in the Asia Pacific region

Mitchell

Ang²,

Mercado-Asis³

et al. 2022

Arch Osteoporos

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Summary This narrative review summarises ongoing challenges and progress in the care and prevention of fragility fractures across the Asia Pacific region since mid-2019. The approaches taken could inform development of national bone health improvement Road Maps to be implemented at scale during the United Nations ‘Decade of Healthy Ageing’. Purpose This narrative review summarises recent studies that characterise the burden of fragility fractures, current care gaps and quality improvement initiatives intended to improve the care and prevention of fragility fractures across the Asia Pacific region. Methods The review focuses on published studies, reports and quality improvement initiatives undertaken during the period July 2019 to May 2022. Results Epidemiological studies conducted in countries and regions throughout Asia Pacific highlight the current and projected increasing burden of fragility fractures. Recent studies and reports document a persistent and pervasive post-fracture care gap among people who have sustained fragility fractures. Global initiatives developed by the Fragility Fracture Network and International Osteoporosis Foundation have gained significant momentum in the Asia Pacific region, despite the disruption caused by the COVID-pandemic. The Asia Pacific Fragility Fracture Alliance has developed educational resources including a Hip Fracture Registry Toolbox and a Primary Care Physician Education Toolkit. The Asia Pacific Osteoporosis and Fragility Fractures Society—a new section of the Asia Pacific Orthopaedic Association—is working to engage orthopaedic surgeons across the region in the care and prevention of fragility fractures. The Asia Pacific Consortium on Osteoporosis developed a framework to support national clinical guidelines development groups. Considerable activity at the national level is evident in many countries across the region. Conclusion Development and implementation of national Road Maps informed by the findings of this review are urgently required to respond to the epidemiological emergency posed by fragility fractures during the United Nations ‘Decade of Healthy Ageing’.

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The effectiveness of Police General Hospital’s fracture liaison service (PGH’s FLS) implementation after 5 years: A prospective cohort study

Cited by 11 publications

References 23 publications

Mortality and outcome in fragility hip fracture care during COVID-19 pandemic in Police General Hospital, Thailand

Mortality and outcome in fragility hip fracture care during COVID-19 pandemic in Police General Hospital, Thailand

Secondary fracture rates and risk factors 1 year after a proximal femoral fracture under FLS

Quality improvement initiatives in the care and prevention of fragility fractures in the Asia Pacific region

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