The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture

McLellan, A. R.; Gallacher, Stephen J.; Fraser, Mayrine; McQuillian, Carol

doi:10.1007/s00198-003-1507-z

Cited by 384 publications

(282 citation statements)

References 25 publications

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“…A nurse-centered management program is shown to be effective in coordinating interdisciplinary care, as others have demonstrated for other diseases (31)(32)(33)(34)(35)(36)(37). Direct referral from orthopedics to an osteoporosis care service is also critical to providing reliable care, as previously reported from Switzerland, Canada, and Scotland (13)(14)(15). Clinical process management software, such as that we are using, is essential to organizing the program's work.…”

Section: Discussionmentioning

confidence: 70%

“…Our performance continues to improve in 2004 as these new processes become part of routine postfracture care. Weaker interventions that simply overlaid traditional care, such as educating and prompting busy primary physicians, did not work in our system, nor have they worked elsewhere for osteoporosis or other chronic diseases (10,11,15,29,30). In fact, our more successful approach is very similar to those reported in other countries (13)(14)(15), and is fundamentally different from traditional delivery processes in the United States and elsewhere.…”

Section: Discussionmentioning

confidence: 81%

“…At least 16 publications have documented that fracture patients have seldom had a DXA or preventive treatment before fracturing, nor are they offered diagnosis and treatment afterwards (among the most recent, references 8 -12). In contrast, only a few examples of more dependable care have been reported, all from outside of the United States (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Redesigning the care of fragility fracture patients to improve osteoporosis management: A health care improvement project

Harrington¹,

Barash²,

Day³

et al. 2005

Arthritis & Rheumatism

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Objective. To develop new processes that assure more reliable, population-based care of fragility fracture patients. Methods. A 4-year clinical improvement project was performed in a multispecialty, community practice health system using evidence-based guidelines and rapid cycle process improvement methods (plan-do-study-act cycles). Results. Prior to this project, appropriate osteoporosis care was provided to only 5% of our 1999 hip fracture patients. In 2001, primary physicians were provided prompts about appropriate care (cycle 1), which resulted in improved care for only 20% of patients. A process improvement pilot in 2002 (cycle 2) and full program implementation in 2003 (cycle 3) have assured osteoporosis care for all willing and able patients with any fragility fracture. Altogether, 58% of 2003 fragility fracture patients, including 46% of those with hip fracture, have had a bone measurement, have been assigned to osteoporosis care with their primary physician or a consultant, and are being monitored regularly. Only 19% refused osteoporosis care. Key process improvements have included using orthopedic billings to identify patients, referring patients directly from orthopedics to an osteoporosis care program, organizing care with a nurse manager and process management computer software, assigning patients to primary or consultative physician care based on disease severity, and monitoring adherence to therapy by telephone. Conclusion. Reliable osteoporosis care is achievable by redesigning clinical processes. Performance data motivate physicians to reconsider traditional approaches. Improving the care of osteoporosis and other chronic diseases requires coordinated care across specialty boundaries and health system support.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Redesigning the care of fragility fracture patients to improve osteoporosis management: A health care improvement project

Harrington¹,

Barash²,

Day³

et al. 2005

Arthritis & Rheumatism

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“…It should be noted that vertebral fractures make up only a small proportion of FLS case loads [38][39][40][41][42][43][44][45], as shown in table 3. This is an important shortcoming which must be addressed because vertebral fractures are the most common fragility fracture and are underdiagnosed throughout the world [46].…”

Section: Secondary Fracture Preventionmentioning

confidence: 99%

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

et al. 2017

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-none for this submission. EVM -none for this submission. JAK and PJM have undertaken consultancy for governments, national osteoporosis societies, healthcare professional organisations and private sector companies relating to systematic approaches to fragility fracture care and prevention. JYR has no disclosures related to this work, and has received consultancy, lecture fees and grant support from Amgen, Analis, Asahi Kasei, Boehringer, Bristol Myers Squibb, Chiltern, Danone, Ebewee Pharma, Endocyte, Galapagos, GlaxoSmithKline, IBSAGenevrier, Lilly, Merck Sharp and Dohme, Merckle, Negma, Novartis, NovoNordisk, NPS, Nycomed-Takeda, Organon, Pfizer, PharmEvo, Radius Health, Roche, Rottapharm, Servier, Teijin, Teva, Theramex, Therabel, UCB, Will Pharma, Wyeth, Zodiac. NCWH has no disclosures related to this work, and has received consultancy, lecture fees and honoraria from Alliance for Better Bone Health, AMGEN, MSD, Eli Lilly, Servier, Shire, Consilient Healthcare and Internis Pharma. PJM serves as a consultant to the International Osteoporosis Foundation and received remuneration for his contribution to this manuscript. RR has received honoraria for participation in Advisory boards or speaker bureau fees from Danone, Labatec, Nestlé, and ObsEva. Introduction-This narrative review considers the key challenges facing healthcare professionals and policymakers responsible for providing care to populations in relation to bone health. These challenges broadly fall into 4 distinct themes: Europe PMC Funders Group

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“…The need for improved management in such a vulnerable population is clear and guidelines and initiatives have previously attempted to promote such an improvement. 6,7 The long-term mortality of patients with hip fracture highlights the need to consider factors at the time of fracture, as well as comorbidities, to improve the long-term outcome. The increased risk of further fractures adding to morbidity and mortality is another important consideration, and standardised…”

Section: Kristina åKesson and Anthony D Woolfmentioning

confidence: 99%

Risk of death persists for years after hip fracture

Åkesson

Woolf

2010

Nat Rev Rheumatol

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The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture

Cited by 384 publications

References 25 publications

Redesigning the care of fragility fracture patients to improve osteoporosis management: A health care improvement project

Redesigning the care of fragility fracture patients to improve osteoporosis management: A health care improvement project

Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures

Risk of death persists for years after hip fracture

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