Patel Shaan, Daniels Natasha Faye, Lim Jiang An, Zhou Andrew Kailin, Thahir Azeem, Krkovic Matija
Department of Trauma And Orthopaedics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, Cambridge, United Kingdom.
School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
Curr Rheumatol Rev. 2023;19(1):36-41. doi: 10.2174/1573397118666220510162127.
Osteoporosis is an important public health concern, with secondary fragility fractures carrying a poor prognosis. The role of a Fracture Liaison Service (FLS) is to identify fragility fracture patients via investigation and risk assessment. This serves to address the osteoporosis treatment care gap that exists where the majority of patients with a new fragility fracture over 50-years-old fail to receive a bone mass density (BMD) scan and osteoporosis treatment, ultimately receiving inadequate care. Osteoporosis medication is effective in reducing secondary fragility fractures. However, treatment adherence poses a problem. The FLS serves to prevent more serious secondary fragility fractures such as hip fractures. This minimises operative costs and the cost of postoperative care and results in fewer secondary care and care home admissions, increasing healthcare savings. Implementation of the FLS is effective in increasing investigation, treatment initiation, and adherence, with a corresponding decrease in refracture rate and mortality. This paper aims to evaluate the previous osteoporosis treatment care gap, the effectiveness of osteoporosis medications currently available, and finally, the cost and clinical effectiveness of the FLS serving as a secondary prevention tool.
骨质疏松症是一个重要的公共卫生问题，继发性脆性骨折的预后较差。骨折联络服务（FLS）的作用是通过调查和风险评估来识别脆性骨折患者。这有助于解决存在的骨质疏松症治疗护理缺口，即大多数50岁以上的新发脆性骨折患者未能接受骨密度（BMD）扫描和骨质疏松症治疗，最终得到的护理不足。骨质疏松症药物在减少继发性脆性骨折方面是有效的。然而，治疗依从性是一个问题。FLS有助于预防更严重的继发性脆性骨折，如髋部骨折。这将手术成本和术后护理成本降至最低，并减少二级护理和养老院入住率，从而增加医疗保健储蓄。实施FLS在增加调查、开始治疗和提高依从性方面是有效的，同时骨折再发率和死亡率相应降低。本文旨在评估以前的骨质疏松症治疗护理缺口、目前可用的骨质疏松症药物的有效性，以及最后，作为二级预防工具的FLS的成本和临床有效性。
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