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Experience of a systematic approach to care and prevention of fragility fractures in New Zealand

Gill, C.E. ; Åkesson, K. LU and Harris, R. (2022) In Archives of Osteoporosis 17(1).
Abstract
Summary: This narrative review describes efforts to improve the care and prevention of fragility fractures in New Zealand from 2012 to 2022. This includes development of clinical standards and registries to benchmark provision of care, and public awareness campaigns to promote a life-course approach to bone health. Purpose: This review describes the development and implementation of a systematic approach to care and prevention for New Zealanders with fragility fractures, and those at high risk of first fracture. Progression of existing initiatives and introduction of new initiatives are proposed for the period 2022 to 2030. Methods: In 2012, Osteoporosis New Zealand developed and published a strategy with objectives relating to people who... (More)
Summary: This narrative review describes efforts to improve the care and prevention of fragility fractures in New Zealand from 2012 to 2022. This includes development of clinical standards and registries to benchmark provision of care, and public awareness campaigns to promote a life-course approach to bone health. Purpose: This review describes the development and implementation of a systematic approach to care and prevention for New Zealanders with fragility fractures, and those at high risk of first fracture. Progression of existing initiatives and introduction of new initiatives are proposed for the period 2022 to 2030. Methods: In 2012, Osteoporosis New Zealand developed and published a strategy with objectives relating to people who sustain hip and other fragility fractures, those at high risk of first fragility fracture or falls and all older people. The strategy also advocated formation of a national fragility fracture alliance to expedite change. Results: In 2017, a previously informal national alliance was formalised under the Live Stronger for Longer programme, which includes stakeholder organisations from relevant sectors, including government, healthcare professionals, charities and the health system. Outputs of this alliance include development of Australian and New Zealand clinical guidelines, clinical standards and quality indicators and a bi-national registry that underpins efforts to improve hip fracture care. All 22 hospitals in New Zealand that operate on hip fracture patients currently submit data to the registry. An analogous approach is ongoing to improve secondary fracture prevention for people who sustain fragility fractures at other sites through nationwide access to Fracture Liaison Services. Conclusion: Widespread participation in national registries is enabling benchmarking against clinical standards as a means to improve the care of hip and other fragility fractures in New Zealand. An ongoing quality improvement programme is focused on eliminating unwarranted variation in delivery of secondary fracture prevention. © 2022, International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation. (Less)
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Contribution to journal
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published
subject
keywords
Fracture liaison service, Fragility fracture, Registry, Systematic approach, awareness, fragility fracture, general practitioner, health care personnel, health care system, high risk patient, hip fracture, human, life course perspective, New Zealand, osteoporosis, practice guideline, Review, total quality management, workforce, aged, Australia, complication, secondary prevention, Aged, Hip Fractures, Humans, Osteoporosis, Osteoporotic Fractures, Secondary Prevention
in
Archives of Osteoporosis
volume
17
issue
1
article number
108
publisher
Springer
external identifiers
  • scopus:85135277107
  • pmid:35917039
ISSN
1862-3522
DOI
10.1007/s11657-022-01138-1
language
English
LU publication?
yes
id
06509ea3-5cbe-44ac-a5bb-800a8270d121
date added to LUP
2022-09-16 10:23:20
date last changed
2022-09-17 03:00:03
@article{06509ea3-5cbe-44ac-a5bb-800a8270d121,
  abstract     = {{Summary: This narrative review describes efforts to improve the care and prevention of fragility fractures in New Zealand from 2012 to 2022. This includes development of clinical standards and registries to benchmark provision of care, and public awareness campaigns to promote a life-course approach to bone health. Purpose: This review describes the development and implementation of a systematic approach to care and prevention for New Zealanders with fragility fractures, and those at high risk of first fracture. Progression of existing initiatives and introduction of new initiatives are proposed for the period 2022 to 2030. Methods: In 2012, Osteoporosis New Zealand developed and published a strategy with objectives relating to people who sustain hip and other fragility fractures, those at high risk of first fragility fracture or falls and all older people. The strategy also advocated formation of a national fragility fracture alliance to expedite change. Results: In 2017, a previously informal national alliance was formalised under the Live Stronger for Longer programme, which includes stakeholder organisations from relevant sectors, including government, healthcare professionals, charities and the health system. Outputs of this alliance include development of Australian and New Zealand clinical guidelines, clinical standards and quality indicators and a bi-national registry that underpins efforts to improve hip fracture care. All 22 hospitals in New Zealand that operate on hip fracture patients currently submit data to the registry. An analogous approach is ongoing to improve secondary fracture prevention for people who sustain fragility fractures at other sites through nationwide access to Fracture Liaison Services. Conclusion: Widespread participation in national registries is enabling benchmarking against clinical standards as a means to improve the care of hip and other fragility fractures in New Zealand. An ongoing quality improvement programme is focused on eliminating unwarranted variation in delivery of secondary fracture prevention. © 2022, International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.}},
  author       = {{Gill, C.E. and Åkesson, K. and Harris, R.}},
  issn         = {{1862-3522}},
  keywords     = {{Fracture liaison service; Fragility fracture; Registry; Systematic approach; awareness; fragility fracture; general practitioner; health care personnel; health care system; high risk patient; hip fracture; human; life course perspective; New Zealand; osteoporosis; practice guideline; Review; total quality management; workforce; aged; Australia; complication; secondary prevention; Aged; Hip Fractures; Humans; Osteoporosis; Osteoporotic Fractures; Secondary Prevention}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Springer}},
  series       = {{Archives of Osteoporosis}},
  title        = {{Experience of a systematic approach to care and prevention of fragility fractures in New Zealand}},
  url          = {{http://dx.doi.org/10.1007/s11657-022-01138-1}},
  doi          = {{10.1007/s11657-022-01138-1}},
  volume       = {{17}},
  year         = {{2022}},
}