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Meeting international standards of secondary fracture prevention: a survey on Fracture Liaison Services in the Netherlands

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Abstract

Summary

The Fracture Liaison Service (FLS) is advocated to be effective for the prevention of secondary fractures, but implementation is variable. A questionnaire based on the International Osteoporosis Foundation (IOF) Capture the Fracture® FLS standards was used in the current study. The results showed high compliancy with the IOF standards in the Dutch responding hospitals.

Introduction

The FLS is advocated for the prevention of secondary fractures, but its implementation varies between hospitals and countries. The present survey applied the standards proposed by the IOF to evaluate the implementation of FLSs in non-university hospitals in the Netherlands.

Methods

A questionnaire based on the IOF FLS standards was used in this study, requesting the selection, evaluation and treatment data of patients older than 50 years with a recent fracture.

Results

Of 90 invited hospitals, 24 (27 %) fully responded, providing data of 24,468 consecutive patients, corresponding with 25 % of fracture patients in the Netherlands in the year 2012. After excluding skull and toe fractures and patients exceeding the upper age limits applied by individual hospitals, 11,983 patient data were available for analysis. The data showed high compliance (>90 %) for fracture patient identification, invitation for FLS, timing of assessment, identification of vertebral fractures, application of national guidelines, evaluation of secondary osteoporosis, drug initiation when indicated, communication with the general practitioner and application of follow-up strategy and 70 % for fall prevention. The response rate was on average (49 %).

Conclusions

The available data also showed that patients attending the FLSs were evaluated, treated and followed in high compliancy with the IOF standards. Some standards are open to different interpretations and may need further specification. The major shortcoming in FLS practice was that patients invited to attend the FLSs showed a low response rate. None of the hospitals achieved the IOF standard patient response rate of over 90 %.

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Acknowledgments

The authors are grateful to Lisette van Hulst for her critical linguistic advice and to Agnes Offenberg, president of the board of the Dutch Osteoporosis Nurses Society VF&O, and Harry van den Broek, president of the board of the Dutch Osteoporosis Patient Association for their enthusiastic support.

Conflicts of interest

None

Author information

Authors and Affiliations

  1. Department of Orthopaedics and Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands

    P. van den Berg

  2. Department of Internal Medicine, Reinier de Graaf Gasthuis, Delft, The Netherlands

    D. H. Schweitzer

  3. Department of Medical Laboratories, Association of Clinical Chemistry, Reinier de Graaf Gasthuis, Delft, The Netherlands

    P. M. M. van Haard

  4. Department of Internal Medicine, VieCuri Medical Centre Noord-Limburg, Maastricht, The Netherlands

    J. P. van den Bergh

  5. Department of Internal Medicine, Subdivision Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands

    J. P. van den Bergh & P. P. Geusens

  6. Hasselt University, Diepenbeek, Belgium

    P. P. Geusens

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  1. P. van den Berg
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Correspondence to P. van den Berg.

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van den Berg, P., Schweitzer, D.H., van Haard, P.M.M. et al. Meeting international standards of secondary fracture prevention: a survey on Fracture Liaison Services in the Netherlands. Osteoporos Int 26, 2257–2263 (2015). https://doi.org/10.1007/s00198-015-3117-y

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  • DOI: https://doi.org/10.1007/s00198-015-3117-y

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