The Fracture Liaison Service to close the osteoporosis care gap: a leadership educational model for undergraduate and postgraduate trainees

Yu, Micah; Downey, Christina; Torralba, Karina D.

doi:10.1007/s10067-019-04796-8

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…FLS programmes) at their respective institutions. It has been shown that interdisciplinary FLS programmes (such as those focused on endocrinology, geriatrics, and orthopaedic surgery) can be successful in increasing rates of post-fracture osteoporotic treatment [ 30 ]. Based on the results presented here, not only are the CoP participants likely to go forward in setting up FLS programmes themselves, but we believe they will be equipped with the right competencies to lead interdisciplinary teams.…”

Section: Discussionmentioning

confidence: 99%

Preparing the Leaders of Tomorrow: Learnings from a Two-Year Community of Practice in Fragility Fractures

Murray

Langdahl

Casado³

et al. 2022

Journal of European CME

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To facilitate the development of leadership competencies in a multidisciplinary group of 18 emerging bone experts from 6 European Countries and Brazil, to face future scenarios in the evolving field of fragility fractures, and to support secondary fracture prevention and improve patient outcomes. Changes brought by the COVID-19 pandemic have further highlighted this need. A 2.5-year community of practice (CoP) programme was established with two senior bone experts acting as mentors. The content was adapted during the COVID-19 pandemic. The education impact of the programme was assessed using an ethics-approved mixed-method design consisting of multiple sources of qualitative and quantitative data collected longitudinally. Quantitative data were analysed descriptively. Qualitative data underwent a thematic analysis. After participating in the programme, participants reported increased interprofessional collaboration and communication skills, better understanding of health economics and negotiation, application of adult learning principles to their work setting, development of competencies to critically appraise guidelines, enhanced abilities to facilitate behaviour change in others, and improved confidence leading their team through crisis situations. Although time was required for some physicians to get accustomed to the CoP concept and develop trust with other members, it was described as a beneficial real-world learning experience. An educational real-world CoP programme was effective in enhancing leadership competencies among future leaders in the bone field to improve care of fragility fracture patients. The results presented could guide the development of other CoPs in fragility fracture care as leadership competencies are increasingly required in that field.

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Section: Discussionmentioning

confidence: 99%

Preparing the Leaders of Tomorrow: Learnings from a Two-Year Community of Practice in Fragility Fractures

Murray

Langdahl

Casado³

et al. 2022

Journal of European CME

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“…Another factor underlying the limited number of FLS seems to be a lack of education and awareness on the importance of secondary prevention in those that have experienced a recent fracture. It is worthy of note that many patients, despite having sustained a fracture, may be unaware that they have OP [96]. In this regard, education in understanding the need for FLSs at a physician and patient level, and increasing the availability of resources for their establishment, will have the potential to increase the number FLSs.…”

Section: Fracture Liaison Servicesmentioning

confidence: 99%

The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations

et al. 2021

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Purpose The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults. In this article, we outlined the current situation of OP in older adults in Turkey and investigated the differences between Turkey and a representative developed European country (Belgium), in terms of the screening, diagnosis, and treatment of OP. Our intention in this regard was to identify areas in need of improvement and subsequently to make a clear call for action to address these issues. Methods Herein, considering the steps related to the OP approach, we made a complete review of the studies conducted in Turkey and compared with the literature recommendations. Results There is a need for a national osteoporotic fracture registry; measures should be taken to improve the screening and treatment of OP in older males, such as educational activities; technicians involved in dual-energy X-ray absorptiometry (DXA) scanning should undergo routine periodic training; all DXA centers should identify center-specific least significant change values; all older adults should be considered for routine lateral dorsolumbar X-ray imaging for the screening of vertebral fractures while ordering DXA scans; the inclusion of vertebral fracture assessment (VFA) software in DXA assessments should be considered; screening using a fracture risk assessment tool (FRAX) algorithm that is specific to Turkey should be integrated; the fortification of foods with vitamin D is required; the high fracture risk by country-specific FRAX algorithm and the presence of falls/high fall risk should be integrated in reimbursement terms; and finally, more "fracture liaison services" should be established. ConclusionWe suggest that the practical consideration of our suggestions will provide considerable support to the efforts for combating with the adverse consequences of OP in society. This approach can be subsequently modeled for other populations to improve the management of OP globally. KeywordsOsteoporosis • Current situation • Turkey • Older • Improvement Abbreviations BMD Bone mineral density DXA Dual-energy X-ray absorptiometry eGFR Estimated glomerular filtration rate ESCEO Economic evaluation of osteoporosis and osteoarthritis * Gulistan Bahat

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Suboptimal osteoporosis care in hospitalized patients: a retrospective analysis of vertebral compression fractures detected on computed tomography

Minalyan,

Li,

D’Anna

et al. 2024

Rheumatol Int

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Vertebral compression fractures (VCFs) are the most common osteoporotic fractures. Only 1/3 of patients with VCFs are clinically diagnosed. In our institution, the Fracture Liaison Service (FLS) was launched in 2017 to improve osteoporosis management for hospitalized patients. (1) To assess osteoporosis awareness among medical providers for emergency department (ED)/hospitalized patients aged 50 or greater; (2) To estimate the rate of FLS consults or referrals to primary care providers (FLS/PCP) by primary teams. A centralized radiology system was used to examine all thoracic and lumbar computed tomography (CT) scans conducted between June 1, 2017 and June 1, 2022. 449 studies were identified with the radiologic impression “compression fracture”. 182 studies were excluded after manual chart review. 267 hospitalizations/ED visits with lumbar and/or thoracic spine CT scans were included. Referrals to FLS (26) or PCP (27) were made in 53 cases (~ 20% of the total). In the ED subgroup (131 hospitalizations), only 17 patients had FLS/PCP referrals. The “compression fracture” was mentioned in 227 (85%) discharge notes (any part), while “osteoporosis” was mentioned in only 74 (28%) hospitalizations. A statistically significant difference was found between the two groups when “osteoporosis” was mentioned in the “assessment and plan” section (p = 0.02). Our data show that the overall osteoporosis care for affected patients is suboptimal. Medical providers often overlook the presence of osteoporosis, leading to a lack of consultation with the FLS of referral to PCPs for further evaluation and treatment.

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The Fracture Liaison Service to close the osteoporosis care gap: a leadership educational model for undergraduate and postgraduate trainees

Cited by 3 publications

References 22 publications

Preparing the Leaders of Tomorrow: Learnings from a Two-Year Community of Practice in Fragility Fractures

Preparing the Leaders of Tomorrow: Learnings from a Two-Year Community of Practice in Fragility Fractures

The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations

Suboptimal osteoporosis care in hospitalized patients: a retrospective analysis of vertebral compression fractures detected on computed tomography

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