Hvidovre Hospital

The FLS service covers in -and out patients with fragility fracture in Copenhagen University Hospital Hvidovre, Copenhagen Denmark.

 

We started in 2009, with Hip fragility patients, and in 2015 we expanded our service to all fragility fracture patients.

FLS has, 5 general practitioner, 5 nurses and 2 Technician.

FLS works in close collaboration with Department of Orthopedics and Emergency Department/Room and Rehabilitation Center

Our FLS staff, works in 2 teams, : Hip fracture Team, and : Non hip fracture team. All  fracture patient records are evaluated by the two FLS-nurses biweekly with use of a developed FLS-algorithm evaluating mental status, age and co-morbidities. Relevant patients are then bedside by the two FLS-nurses offered an outpatient clinic visit in the Dep. of Osteoporosis scheduled within 3-6 months postop. Here DXA-scans incl. VFA and blood samples are taken before the osteoporosis specialists examine and treat the patients.

Patients with Non Hip Fracture, have to call our FLS service for appointment. In orthopedics out patients unit and in emergency room, we have put up posters and pamphlets explaining the connection between fracture and osteoporosis. Our phone number is on the pamphlets and all patients with fractures, can call us have DXA scan performed. The staff at Orthopedics out patients clinic, Emergency room and rehabilitation center are also requested to hand out the pamphlets to patient with fracture.

 

 

Our results: 

 

At FNN congress 2016, we participated with abstract and oral presentation.

All 524 consecutive HF-patients admitted during 2014 were evaluated by the two FLS-nurses, who found 75% (393/524) to be candidates for an invitation to a follow-up visit in the osteoporosis outpatient clinic, 59% (312/524) accepted the invitation and were scheduled for a follow-up visit. 34% (178/524) met for examination in the outpatient clinic, where 22% (113/524) were given anti-osteoporotic treatment. This latter increased from 16% in 2013. 

With this FLS-model, we reached a slightly higher rate of anti-osteoporotic treatment than most often described among HF-patients. The large group of invited patients not showing up in the outpatient clinic is a challenge and new actions are required to further increase the osteoporosis treatment subsequent to HFs.