Hospital Universitario Virgen Macarena

The FLS of the Virgen Macarena University Hospital got rolling in 2015. The Virgen Macarena University Hospital is a public hospital of the third level. It has 850 beds and serves up to 500,000 inhabitants of Seville.

Since its inception, the FLS has two main bases: clinical care and research. In a clinical level, the team is made up of 1. Three specialized doctors from the Internal Medicine and Rheumatology Departments. 2. A Nurse Case Management who coordinates the consultations. 3. Two radiology technicians who perform densitometric tests and 4. A secretary. Besides, the FLS is supported by other Hospital services such as Trauma surgery and Orthopaedics, Rehabilitation, Emergency Unit, Plaster Room Unit, and almost 50 out-of-hospital Primary Care Centres for patient recruitment and referral. This multidisciplinary team allow us to collect fragility fractures at an inpatient hospital level, and patients who do not require hospitalization as well as vertebral compression fractures.

In the FLS, the patients (usually over 50 years) are assessed in a single medical consultation. In this visit all patients´ data are recorded in a database (Openclinica®). The evaluation includes assessment of OP and fracture risk factors, physical examination, nutritional status, muscular strength, muscle ultrasound, fall risk, survival tests, spine X-rays, blood tests and densitometry. With these data a diagnosis is established, and the treatment protocol begins. These treatment protocols include secondary prevention: hygienic-dietary measures, pharmacological therapy, nutritional treatment (if applicable), and physical therapy with exercises for collapsing prevention. The patients are followed-up in the Primary Care Centres, and those with at significant risk of further fractures or with clinical criteria of severity are checked by FLS practitioners.

Telematic consultations are available to quickly and fluidly communicate Primary Care and FLS, and to request for densitometry testing by Primary Care professionals. At the research level, professors of the Faculty of Medicine of the University of Seville -a team with extensive experience in bone and mineral metabolism- support the FLS in epidemiological, clinical and basic research, with the aim of advancing in the knowledge of OP and its complexities