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Osteoporosis International

, Volume 26, Issue 11, pp 2573–2578 | Cite as

Effective secondary fracture prevention: implementation of a global benchmarking of clinical quality using the IOF Capture the Fracture® Best Practice Framework tool

  • M. K. Javaid
  • C. Kyer
  • P. J. Mitchell
  • J. Chana
  • C. Moss
  • M. H. Edwards
  • A. R. McLellan
  • J. Stenmark
  • D. D. Pierroz
  • M. C. Schneider
  • J. A. Kanis
  • K. Akesson
  • C. CooperEmail author
  • IOF Fracture Working Group
  • EXCO
Original Article

Abstract

Summary

Fracture Liaison Services are the best model to prevent secondary fractures. The International Osteoporosis Foundation developed a Best Practice Framework to provide a quality benchmark. After a year of implementation, we confirmed that a single framework with set criteria is able to benchmark services across healthcare systems worldwide.

Introduction

Despite evidence for the clinical effectiveness of secondary fracture prevention, translation in the real-world setting remains disappointing. Where implemented, a wide variety of service models are used to deliver effective secondary fracture prevention. To support use of effective models of care across the globe, the International Osteoporosis Foundation’s Capture the Fracture® programme developed a Best Practice Framework (BPF) tool of criteria and standards to provide a quality benchmark. We now report findings after the first 12 months of implementation.

Methods

A questionnaire for the BPF was created and made available to institutions on the Capture the Fracture website. Responses from institutions were used to assign gold, silver, bronze or black (insufficient) level of achievements mapped across five domains. Through an interactive process with the institution, a final score was determined and published on the Capture the Fracture website Fracture Liaison Service (FLS) map.

Results

Sixty hospitals across six continents submitted their questionnaires. The hospitals served populations from 20,000 to 15 million and were a mix of private and publicly funded. Each FLS managed 146 to 6200 fragility fracture patients per year with a total of 55,160 patients across all sites. Overall, 27 hospitals scored gold, 23 silver and 10 bronze. The pathway for the hip fracture patients had the highest proportion of gold grading while vertebral fracture the lowest.

Conclusion

In the first 12 months, we have successfully tested the BPF tool in a range of health settings across the globe. Initial findings confirm a significant heterogeneity in service provision and highlight the importance of a global approach to ensure high quality secondary fracture prevention services.

Keywords

Adherence Best Practice Framework Falls prevention Fracture Liaison Service Hip fracture Osteoporosis Secondary fracture prevention Vertebral fracture 

Notes

Acknowledgments

The authors would like to thank all the FLS applicants for taking part of the Capture the Fracture programme.

Conflicts of interest

None.

Supplementary material

198_2015_3192_MOESM1_ESM.pdf (196 kb)
ESM 1 (PDF 196 kb)

References

  1. 1.
    Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17(12):1726–1733CrossRefPubMedGoogle Scholar
  2. 2.
    Hernlund E (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8(1–2):136PubMedCentralCrossRefPubMedGoogle Scholar
  3. 3.
    Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767CrossRefPubMedGoogle Scholar
  4. 4.
    Akesson K, Mitchell PJ (2012) Capture the fracture a global campaign to break the fragility fracture cycle. World Osteoporosis Day Report 2012 [Report] 2012; Available from: http://www.iofbonehealth.org/reports
  5. 5.
    Marsh D et al (2011) Coordinator-based systems for secondary prevention in fragility fracture patients. Osteoporos Int 22(7):2051–2065CrossRefPubMedGoogle Scholar
  6. 6.
    Eisman JA et al (2012) Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res 27(10):2039–2046CrossRefPubMedGoogle Scholar
  7. 7.
    Ganda K et al (2013) Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int 24(2):393–406CrossRefPubMedGoogle Scholar
  8. 8.
    Sale JE et al (2011) Systematic review on interventions to improve osteoporosis investigation and treatment in fragility fracture patients. Osteoporos Int 22(7):2067–2082CrossRefPubMedGoogle Scholar
  9. 9.
    Kanis JA et al (2013) SCOPE: a scorecard for osteoporosis in Europe. Arch Osteoporos 8(1–2):144PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Mithal A, Ebeling P, Kyer C (2013) The Asia-Pacific Regional Audit: epidemiology, costs & burden of osteoporosis in 2013. 2013; Report]. Available from: http://www.iofbonehealth.org/regional-audits
  11. 11.
    Canada O (2014) Quality standards for fracture liaison services in CanadaGoogle Scholar
  12. 12.
    Zealand ON (2014) Fracture liaison services resource packGoogle Scholar
  13. 13.
    Adams J et al (2011) Vertebral fracture teaching programGoogle Scholar
  14. 14.
    Lindley RI (2014) Hip fracture: the case for a funded national registry. Med J Aust 201(7):368–369CrossRefPubMedGoogle Scholar
  15. 15.
    Thorngren KG (2008) National registration of hip fractures. Acta Orthop 79(5):580–582CrossRefPubMedGoogle Scholar
  16. 16.
    Heikkinen T et al (2005) Evaluation of 238 consecutive patients with the extended data set of the Standardised Audit for Hip Fractures in Europe (SAHFE). Disabil Rehabil 27(18–19):1107–1115CrossRefPubMedGoogle Scholar
  17. 17.
    Currie CT, Hutchison JD (2005) Audit, guidelines and standards: clinical governance for hip fracture care in Scotland. Disabil Rehabil 27(18–19):1099–1105CrossRefPubMedGoogle Scholar
  18. 18.
    Fadda V et al (2014) Gastrointestinal and renal side effects of bisphosphonates: differentiating between no proof of difference and proof of no difference. J Endocrinol InvestGoogle Scholar
  19. 19.
    Chang KH et al (2014) Increased risk of dementia in patients with osteoporosis: a population-based retrospective cohort analysis. Age (Dordr) 36(2):967–975CrossRefGoogle Scholar
  20. 20.
    Knopp-Sihota JA et al (2014) Dementia diagnosis and osteoporosis treatment propensity: a population-based nested case-control study. Geriatr Gerontol Int 14(1):121–129CrossRefPubMedGoogle Scholar
  21. 21.
    Gleason LJ et al (2012) Diagnosis and treatment of osteoporosis in high-risk patients prior to hip fracture. Geriatr Orthop Surg Rehabil 3(2):79–83PubMedCentralCrossRefPubMedGoogle Scholar
  22. 22.
    Burch J et al (2014) Systematic review of the use of bone turnover markers for monitoring the response to osteoporosis treatment: the secondary prevention of fractures, and primary prevention of fractures in high-risk groups. Health Technol Assess 18(11):1–180CrossRefPubMedGoogle Scholar
  23. 23.
    Vasikaran S et al (2011) International osteoporosis foundation and international federation of clinical chemistry and laboratory medicine position on bone marker standards in osteoporosis. Clin Chem Lab Med 49(8):1271–1274CrossRefPubMedGoogle Scholar
  24. 24.
    Bell KJ et al (2009) Value of routine monitoring of bone mineral density after starting bisphosphonate treatment: secondary analysis of trial data. BMJ 338:b2266PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Hiligsmann M et al (2013) Interventions to improve osteoporosis medication adherence and persistence: a systematic review and literature appraisal by the ISPOR Medication Adherence & Persistence Special Interest Group. Osteoporos Int 24(12):2907–2918CrossRefPubMedGoogle Scholar
  26. 26.
    White HJ et al (2010) A systematic review assessing the effectiveness of interventions to improve persistence with anti-resorptive therapy in women at high risk of clinical fracture. Fam Pract 27(6):593–603CrossRefPubMedGoogle Scholar
  27. 27.
    Rietbrock S, Olson M, van Staa TP (2009) The potential effects on fracture outcomes of improvements in persistence and compliance with bisphosphonates. QJM 102(1):35–42CrossRefPubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2015

Authors and Affiliations

  • M. K. Javaid
    • 1
  • C. Kyer
    • 2
  • P. J. Mitchell
    • 3
    • 4
  • J. Chana
    • 5
  • C. Moss
    • 6
  • M. H. Edwards
    • 6
  • A. R. McLellan
    • 7
  • J. Stenmark
    • 2
  • D. D. Pierroz
    • 2
  • M. C. Schneider
    • 2
  • J. A. Kanis
    • 8
  • K. Akesson
    • 9
  • C. Cooper
    • 1
    • 6
    Email author
  • IOF Fracture Working Group
  • EXCO
  1. 1.NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of OrthopaedicsUniversity of OxfordOxfordUK
  2. 2.International Osteoporosis Foundation (IOF)NyonSwitzerland
  3. 3.Synthesis Medical NZ LtdAucklandNew Zealand
  4. 4.University of Notre Dame AustraliaSydneyAustralia
  5. 5.Stoke Mandeville HospitalAylesburyUK
  6. 6.MRC Lifecourse Epidemiology UnitUniversity of Southampton, Southampton General HospitalSouthamptonUK
  7. 7.EndocrinologyWestern InfirmaryGlasgowUK
  8. 8.Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffieldUK
  9. 9.Department of OrthopaedicsLund University, Skåne University HospitalMalmöSweden

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