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Coordinator-based systems for secondary prevention in fragility fracture patients

Marsh, D.; Åkesson, Kristina LU ; Beaton, D. E.; Bogoch, E. R.; Boonen, S.; Brandi, M. -L.; McLellan, A. R.; Mitchell, P. J.; Sale, J. E. M. and Wahl, D. A. (2011) In Osteoporosis International 22(7). p.2051-2065
Abstract
The underlying causes of incident fractures-bone fragility and the tendency to fall-remain under-diagnosed and under-treated. This care gap in secondary prevention must be addressed to minimise both the debilitating consequences of subsequent fractures for patients and the associated economic burden to healthcare systems. Clinical systems aimed at ensuring appropriate management of patients following fracture have been developed around the world. A systematic review of the literature showed that 65% of systems reported include a dedicated coordinator who acts as the link between the orthopaedic team, the osteoporosis and falls services, the patient and the primary care physician. Coordinator-based systems facilitate bone mineral density... (More)
The underlying causes of incident fractures-bone fragility and the tendency to fall-remain under-diagnosed and under-treated. This care gap in secondary prevention must be addressed to minimise both the debilitating consequences of subsequent fractures for patients and the associated economic burden to healthcare systems. Clinical systems aimed at ensuring appropriate management of patients following fracture have been developed around the world. A systematic review of the literature showed that 65% of systems reported include a dedicated coordinator who acts as the link between the orthopaedic team, the osteoporosis and falls services, the patient and the primary care physician. Coordinator-based systems facilitate bone mineral density testing, osteoporosis education and care in patients following a fragility fracture and have been shown to be cost-saving. Other success factors included a fracture registry and a database to monitor the care provided to the fracture patient. Implementation of such a system requires an audit of existing arrangements, creation of a network of healthcare professionals with clearly defined roles and the identification of a 'medical champion' to lead the project. A business case is needed to acquire the necessary funding. Incremental, achievable targets should be identified. Clinical pathways should be supported by evidence-based recommendations from national or regional guidelines. Endorsement of the proposed model within national healthcare policies and advocacy programmes can achieve alignment of the objectives of policy makers, professionals and patients. Successful transformation of care relies upon consensus amongst all participants in the multi-disciplinary team that cares for fragility fracture patients. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Clinical systems, FLS, Fracture prevention, IOF, Osteoporosis, Osteoporotic fracture
in
Osteoporosis International
volume
22
issue
7
pages
2051 - 2065
publisher
Springer
external identifiers
  • wos:000291227700002
  • scopus:79959990095
ISSN
1433-2965
DOI
10.1007/s00198-011-1642-x
language
English
LU publication?
yes
id
f8fc7a4b-1e7a-41d2-88fc-44583eef6069 (old id 1985233)
date added to LUP
2011-07-01 09:04:00
date last changed
2017-10-29 04:00:10
@article{f8fc7a4b-1e7a-41d2-88fc-44583eef6069,
  abstract     = {The underlying causes of incident fractures-bone fragility and the tendency to fall-remain under-diagnosed and under-treated. This care gap in secondary prevention must be addressed to minimise both the debilitating consequences of subsequent fractures for patients and the associated economic burden to healthcare systems. Clinical systems aimed at ensuring appropriate management of patients following fracture have been developed around the world. A systematic review of the literature showed that 65% of systems reported include a dedicated coordinator who acts as the link between the orthopaedic team, the osteoporosis and falls services, the patient and the primary care physician. Coordinator-based systems facilitate bone mineral density testing, osteoporosis education and care in patients following a fragility fracture and have been shown to be cost-saving. Other success factors included a fracture registry and a database to monitor the care provided to the fracture patient. Implementation of such a system requires an audit of existing arrangements, creation of a network of healthcare professionals with clearly defined roles and the identification of a 'medical champion' to lead the project. A business case is needed to acquire the necessary funding. Incremental, achievable targets should be identified. Clinical pathways should be supported by evidence-based recommendations from national or regional guidelines. Endorsement of the proposed model within national healthcare policies and advocacy programmes can achieve alignment of the objectives of policy makers, professionals and patients. Successful transformation of care relies upon consensus amongst all participants in the multi-disciplinary team that cares for fragility fracture patients.},
  author       = {Marsh, D. and Åkesson, Kristina and Beaton, D. E. and Bogoch, E. R. and Boonen, S. and Brandi, M. -L. and McLellan, A. R. and Mitchell, P. J. and Sale, J. E. M. and Wahl, D. A.},
  issn         = {1433-2965},
  keyword      = {Clinical systems,FLS,Fracture prevention,IOF,Osteoporosis,Osteoporotic fracture},
  language     = {eng},
  number       = {7},
  pages        = {2051--2065},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {Coordinator-based systems for secondary prevention in fragility fracture patients},
  url          = {http://dx.doi.org/10.1007/s00198-011-1642-x},
  volume       = {22},
  year         = {2011},
}