Taiwanese society reports successes in secondary fracture prevention

With 19 Fracture Liaison Services implemented or in development, Taiwanese hospitals are among the Asia-Pacific’s greatest champions of secondary fracture prevention.

At the recent IOF Worldwide Conference of Osteoporosis Patient Societies, the Taiwanese Osteoporosis Association (TOA) received an award for their extensive efforts in support of Fracture Liaison Services (FLS) in Taiwan. The recognition, which was awarded for the best Fracture Liaison Service Campaign among IOF member societies worldwide, was a wonderful way for TOA to celebrate its 20th anniversary this year.

Already, in this comparatively small area within Asia, nineteen FLS have either been implemented or are in development. The Taiwanese Osteoporosis Association has been instrumental in promoting secondary fracture prevention through the implementation of FLS by following four major objectives:

  • Creating an FLS network and holding educational workshops for healthcare professionals
  • Promoting the application of best practice as outlined by the Capture the Fracture® Best Practice Framework
  • Carrying out campaigns directed at the general public to increase awareness about secondary fracture prevention, FLS, and osteoporosis in general.
  • Promoting international collaborations, including with IOF.

The core FLS model in Taiwan focuses on case finding, assessment, and management and follow-up. Patients with new hip fractures, newly identified vertebral fracture and clinical vertebral fractures undergo a complete assessment which includes risk assessment (FRAX), BMD, X-rays, lifestyle, blood work, falls evaluation, and medical review. Management and follow-up includes medication; education about nutrition, exercise and bone-healthy lifestyle; referral to other specialists as required (e.g. rehab, endocrinologist, etc.), telephone reminders, and follow-up at 4, 8, 12, 18 and 24 months. The follow up at regular intervals for up to two years helps to encourage compliance with medication and lifestyle recommendations.

Of the FLS services which have been assessed so far, two have received gold-star and two silver-star recognition by the IOF Capture the Fracture® recognition programme. This recognition, which is highlighted on the CTF Map of Best Practice, attests to the FLS excellence of the services and serves to spur other FLS to improve their services further. 

Dr Paulo Chih-Hsing Wu, president of the Taiwanese Osteoporosis Association, stated:

At the beginning of 2014, Taiwan had two FLS services – now, following our intensive education and awareness efforts, we can boast 19 FLS services across the entire nation.
We strongly believe that the broad implementation of FLS will directly help to prevent suffering and lasting disability caused by secondary fractures in high risk patients. Our next step, and one which would be of great importance, is to advocate for the implementation of FLS into the National Health Insurance program with reimbursement.