Celebrating Gold-Standard Fracture Liaison Services
New Capture the Fracture® campaign launched to highlight the importance of achieving gold-level standards of post-fracture care.
As the world celebrated the highest level of athletic excellence in Paris during the Summer Olympics this year, champions of fracture care worldwide were also performing at gold-medal levels in secondary fracture prevention and osteoporosis management. These champions are the dedicated teams behind specialized post-fracture care coordination programs, commonly known as Fracture Liaison Services (FLS), that play a critical role in preventing future osteoporotic fractures in patients with osteoporosis who experience a first fracture.
To mark this campaign, top-performing FLS services were invited to share their insights about how they deliver gold-standard care. Eighteen of the 120 Gold-level FLS within the Capture the Fracture® (CTF) network, which comprises more than 1000 FLS worldwide, shared images and inspiring quotes from their teams.
What are FLS programmes?
FLS programmes are coordinator-based, secondary fracture prevention services implemented by hospitals or clinics for the treatment of patients with osteoporosis after a fragility fracture. These services are dedicated to ensuring that patients who present with fragility fractures receive comprehensive risk assessments and appropriate treatment. A dedicated coordinator links the patient to key services, such as orthopaedics, falls prevention, and primary care.
Key elements of Gold-Standard FLS
The International Osteoporosis Foundation’s Capture the Fracture® (CTF) programme offers education, evaluation and recognition to FLS worldwide. The Capture the Fracture® Best Practice Framework (BPF) sets the international benchmark for FLS performance, providing guidance to FLS with 13 standards. Hospitals and clinics operating FLS are assessed by completing the BPF Questionnaire, resulting in a bronze, silver or gold score, depending on the level of their service. Among the characteristics of a gold-standard FLS, are these essential features:
- Identification and evaluation of all patients who have sustained all types of fractures, including hip, wrist, and vertebral fractures
- Assessment within 8 weeks of fracture
- Assessment of clinical vertebral fractures as well as opportunistic fractures through radiology
- Assessment and treatment reflecting national peer-reviewed guidelines
- Multifaceted lifestyle risk factor assessment and investigation into secondary causes of osteoporosis
- Falls prevention services
- Initiation and review of anti-osteoporosis medication
- Communication of assessment and treatment recommendations with primary and secondary care
- Follow up with patients within the 1st year and long term follow up after 1 year
- Inclusion of fracture statistics into national fracture databases
Improved patient care, greater treatment initiation and adherence
Dr Carmen Gómez Vaquero, of the Hospital Universitari de Bellvitge FLS in Spain said: “We believe that our efforts are truly helping to reduce the number of fractures in our population, and that is the best reward we could ask for. This motivates us to keep improving how we care for our patients.” This sentiment was shared by other Gold-level FLS, whose team leaders also highlighted the importance of continuous care (ensuring that no patient falls through the cracks); tailored treatment plans and patient-centred approach (which leads to better adherence to interventions); and the importance of teamwork and perseverance (essential qualities in any FLS).
-> View the contributions of participating FLS in Asia Pacific, Europe, and Latin America1
Collaboration and determination central to the pursuit of excellence
Just as Olympians need perseverance, hard work, and financial backing to achieve Gold, so too do FLS. The services require robust support and ongoing funding at both national and local levels to maintain their healthcare teams and to deliver world-class care.
Prof. Maria-Luisa Brandi, Chair of the Capture the Fracture® governance, noted: “It’s a team effort! In the same way that it takes an entire support system for athletes to achieve Olympic success, it takes a dedicated team to deliver excellence in post-fracture care. However, FLS can only maintain excellence, or aspire to improve their service to gold standards, when they can count on long-term investment and support from hospital and health authorities.”
“With this campaign, we not only want to give recognition to gold-standard services and inspire other FLS to ‘go for gold’, but we want to urge local, regional and national health authorities to support these endeavours.”
Dr Philippe Halbout, CEO of the International Osteoporosis Foundation, added: “Gold-standard post-fracture care is a win for everyone. More patients in need of care are identified, and they experience better care, leading to improved outcomes and a reduced risk of secondary fractures. Healthcare systems benefit from lower costs due to fewer fractures, which means less demand for hospital surgeries, hospitalization, and long-term care for dependent patients.”
"This is a vital step toward building healthier lives and stronger healthcare systems worldwide."
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1. Participating FLS:
ASIA PACIFIC: Hayato Orthopedics Hospital, Kagoshima, Japan; Higashiyamato Hospital, Tokyo, Japan; Tokushima Kensei Hospital, Tokushima, Japan; JCHO Tamatsukuri Hospital, Matsue, Japan; Nadogaya Hospital FLS, Kashiwa City, Japan; Waitemata District Health Board (DHB), Takapuna, New Zealand; Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan; Thailand Police General Hospital, Bangkok, Thailand; Siriraj Hospital, Bangkok, Thailand
EUROPE: Presidio Ospedaliero San Giuseppe Moscati, Aversa, Italy; Badalona Serveis Assistencials, Badalona, Spain; Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Spain; Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas, Spain; Center of Bone Diseases, Lausanne University Hospital CHUV, Lausanne, Switzerland; Osteoporose Zentrum Luzern, Lucern, Switzerland; West Glasgow ACH, Glasgow, UK
LATIN AMERICA: Sanatorio Las Lomas, Buenos Aires, Argentina; Clinic Santo Antonio, Bragança Paulista, Brazil
About Capture the Fracture®
Capture the Fracture® (CTF) is a multi-stakeholder initiative, led by the International Osteoporosis Foundation (IOF), to facilitate the implementation of Post-Fracture Care Coordination Programs, such as Fracture Liaison Services (FLS), for secondary fracture prevention. The CTF initiative, which celebrated its 10th anniversary in 2022, aims to drive local and regional change to prioritize secondary fracture prevention. It sets global best practice standards and provides recognition to FLS through its Best Practice Framework (BPF). The CTF program also provides mentoring, resources, and essential documentation to promote the prioritization of secondary fracture prevention and support the implementation and quality improvement of FLS. Since 2020, the growth of the CTF Network has been accelerated by the collaboration and support of industry partners Amgen and UCB, which have provided sponsorship through the Capture the Fracture® Partnership. Currently, the CTF network includes 1029 FLS in 60 countries worldwide. FLS are invited to apply for free evaluation and recognition through the online application platform available on the CTF website. www.capturethefracture.org #CaptureTheFracture
About IOF
The International Osteoporosis Foundation (IOF) is the world’s largest non-governmental organization dedicated to the prevention, diagnosis, and treatment of osteoporosis and related musculoskeletal diseases. IOF members, including scientific research committees and over 335 patient, medical, and research organizations, work together to make fracture prevention and healthy mobility a worldwide healthcare priority. www.osteoporosis.foundation.org