New toolkit to aid implementation of fracture liaison services

Health authorities worldwide are coping with rising costs and disability resulting from fragility fractures in the older population. Yet evidence shows that the burden of fragility fractures could be reduced through early identification and treatment of patients who have previously suffered a fracture. Currently, 80% of individuals who experience a fragility fracture are never offered screening and/or treatment for osteoporosis even though they are twice as likely to suffer a fracture in the future.

Left undiagnosed and unprotected, these patients often go on to experience a cascade of new fractures, including highly disabling and life-threatening hip fractures.

Evidence now shows that Fracture Liaison Services (FLS) are practical and cost-effective ways in which to close the care gap. An FLS employs a dedicated coordinator to act as the link between the patient and the orthopaedic team, the osteoporosis and falls prevention services, and the primary care physician. The coordinator (often a nurse practitioner) enhances communication between the various health-care providers involved and ensures that the patient follows a clearly defined care pathway.

To provide guidance for health-care administrators and policy makers who wish to implement new or improve existing FLS, IOF's Capture the Fracture Steering Committee has now published a practical new toolkit. Available at http://capturethefracture.org/sites/default/files/2014-IOF-CTF-FLS_toolkit.pdf, it comprises four sections:

• Understanding the need for FLS
• FLS implementation guide
• FLS business planning process guide
• Multi-sector FLS coalition guide

Professor Kristina Åkesson, Chair of the Capture the Fracture Campaign and Professor at the Department of Orthopaedics, Malmo Skåne University Hospital, stated, "With a comparatively small investment in fracture liaison services, healthcare facilities can reduce the costs and suffering associated with secondary fractures in their high-risk patients. I encourage health-care providers around the world to make use of this practical and versatile guide to help implement fracture liaison services in their communities."

Launched and managed by the International Osteoporosis Foundation (IOF), the Capture the Fracture initiative website, contains information and resources designed to guide health-care systems worldwide to improve the management of secondary fractures through FLS. It provides internationally endorsed standards for best practice, and through its 'Map of Best Practice' and certificates of achievement, provides recognition for the work of existing FLS.

By working together and sharing best practice, the international healthcare community can make a difference in secondary fracture prevention. Health systems which operate successful fracture liaison services are invited to join the Capture the Fracture coalition and to submit their services for recognition.