Need of Fracture Liaison Services to Treat Patients at Risk of Secondary Fractures

An individual who has sustained one osteoporotic fracture is at twice the risk of debilitating and potentially life-threatening secondary fractures compared to someone who hasn't fractured. A proven method of identifying and managing patients at high risk of fracture is the implementation of coordinator-based Fracture Liaison Services (FLS) in clinics and hospitals. Due to their importance to osteoporosis management, FLS are a key focus of the IOF Regionals 6th Asia-Pacific Osteoporosis Meeting, which opened in Singapore on November 4, 2016, with delegates from more than 50 countries.

Numerous studies have indicated the need for effective secondary fracture prevention with FLS. Unfortunately, studies have also shown that, where there is no FLS or similar service in place, approximately 80% of fragility fracture patients are neither assessed or treated for osteoporosis, the underlying cause of fractures.

Concerted international efforts to implement FLS services, spearheaded by the International Osteoporosis Foundation (IOF) Capture the Fracture® program, have helped to increase the number of services worldwide, including in the Asia-Pacific region. In Singapore, FLS pioneers and leading experts from Australia, India, Japan, Malaysia, Singapore, Chinese Taipei, and Thailand will present their experiences, challenges and outcomes in a dedicated session. In addition, the following new FLS-related research will be presented in scientific abstracts or presentations:

Dr C.-H. Chen, Dept. of Orthopaedics, Kaoshsiung Medical University, Kaohsiung, Taiwan, Province of China presented results of a study of 229 patients of two affiliated hospital FLS which follow the 13 Capture the Fracture® Best Practice Standards. The study found that the FLS was able to increase the rates of assessment and treatment, and has reduced mortality rates after fracture based on comparison with a 2009 study of hip fracture patients without the benefit of FLS services. The Kaoshsiung Medical University FLS has received gold star achievement rating (60%) in the Capture the Fracture® Best Practice Recognition Program. (Abstract OC05)

A Thai study of the FLS at the Police General Hospital, Bangkok, assessed the outcomes for hip fracture patients who participated at the hospital's fracture service. It was found that, compared to a previous study, FLS improved the treatment rate of osteoporosis (from 40.8% to 80%) and helped to prevent secondary osteoporotic fractures (30% to 0%). The Police General Hospital FLS has received gold star achievement rating (72%) in the Capture the Fracture® Best Practice Recognition Program. (Abstract P244)

A study from the Department of Orthopedics, National Taiwan University Hospital, Taipei City, evaluated the outcomes of a local FLS network which includes five hospitals. All hospitals provided falls prevention services, lifestyle assessments and medication review as part of the FLS. The FLS network was able to significantly increase the rates of bone mineral density (BMD) assessment and osteoporosis treatment with 85.1% of the female and 76.7% of the male patients receiving medication. The National Taiwan University Hospital FLS has received gold star achievement rating (60%) in the Capture the Fracture® Best Practice Recognition Program. (Abstract P239)

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Facts on the implementation of the first official FLS service in Malaysia, at the Assunta Hospital, Petaling Jaya, were also presented. After a period of trial and protocol revision, the FLS was accepted as a standard service for in- and out-patients, aged 50 years and older, presenting to the hospital with a low trauma fracture. It is hoped that the model will be adopted by other hospitals in Malaysia. (Abstract P146)

Professor Cyrus Cooper, Chair of the IOF Committee of Scientific Advisors, stated, "Due to its vast and rapidly ageing populations, the Asia- Pacific region is in urgent need of effective FLS to stem the growing tide of osteoporosis-related fractures. These essential services are still rare in the Asian-Pacific and we hope that the strong FLS focus at the 6th Asia-Pacific Osteoporosis Meeting will serve to encourage the implementation of FLS more widely in hospitals throughout the region."

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The IOF Regionals are taking place at the Singapore Convention & Exhibition Center from November 4-6, 2016. Abstracts from the meeting will be published in 'Osteoporosis International'.

Source-Eurekalert