Department of Orthopedic Surgery, Affiliated Lishui Hospital of Zhejiang University, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Municipal Central Hospital, 289 Kuocang Road, Lishui, 323000, Zhejiang Province, China.
Lishui Second People's Hospital, Beihuan Road 69, Liandu District, Lishui, 323000, Zhejiang Province, China.
Arch Osteoporos. 2023 Feb 21;18(1):33. doi: 10.1007/s11657-023-01221-1.
Fracture liaison service (FLS) is a management system for osteoporotic fractures, its difficulty lies in long-term management. Through this pilot single-center study, we found that FLS combined with an internet-based follow-up service (online home nursing care) can economically and conveniently monitor patients, reduce falls and refractures, and improve care and medication adherence.
Among potential e-health platforms, mobile internet encompasses the largest user group of mobile instant messaging software in Asia and offers strong interaction, low cost, and fast speed. The online home nursing care model prevents unnecessary hospital admissions and readmissions. This study aims to explore the effects of a fracture liaison service (FLS) model combined with online home nursing care on patients with fragility hip fracture.
Patients discharged after November 2020 received FLS care combined with online home nursing care. Patients discharged from May 2020 to November 2020 received only routine discharge guidance and were classified as the control group. The Parker Mobility Score (PMS), Medical Outcomes Study 36-item short-form health survey (MOS SF-36), general medication adherence scale (GMAS), complication rate, and fall/refracture rates were used to evaluate the efficacy of the FLS combined with online home nursing care during the 52-week follow-up period.
Eighty-nine patients with complete follow-up information were included in the analysis at the 52-week follow-up. The FLS combined with online home nursing care was associated with improved osteoporosis patient care, including increased medication adherence (64.58% in the control group and 90.24% in the observation group), improved mental quality of life, reduced fall/refracture rate (12.5% and 4.88%, respectively), and reduced rates of bedsores and joint stiffness; however, there was no effect on functional recovery within 1 year.
We recommend the combination of FLS with online home nursing care, considering the local environment, to economically and conveniently monitor patients, reduce falls and refractures, and improve care and medication adherence.
骨折联络服务（FLS）是骨质疏松性骨折的管理系统，其难点在于长期管理。通过这项单中心试点研究，我们发现 FLS 联合基于互联网的随访服务（在线家庭护理）可以经济、方便地监测患者，减少跌倒和再骨折，并提高护理和药物依从性。
在潜在的电子健康平台中，移动互联网涵盖了亚洲最大的移动即时通讯软件用户群体，具有强大的互动性、低成本和快速性。在线家庭护理模式可防止不必要的住院和再入院。本研究旨在探讨骨折联络服务（FLS）模式联合在线家庭护理对脆弱性髋部骨折患者的影响。
2020 年 11 月后出院的患者接受 FLS 联合在线家庭护理。2020 年 5 月至 11 月出院的患者仅接受常规出院指导，并分为对照组。在 52 周的随访期间，使用帕克活动能力评分（Parker Mobility Score，PMS）、健康调查简表 36 项（Medical Outcomes Study 36-item short-form health survey，MOS SF-36）、一般药物依从性量表（general medication adherence scale，GMAS）、并发症发生率和跌倒/再骨折率来评估 FLS 联合在线家庭护理的疗效。
在 52 周的随访中，有 89 例患者的随访信息完整。FLS 联合在线家庭护理可改善骨质疏松症患者的护理，包括提高药物依从性（对照组为 64.58%，观察组为 90.24%）、改善精神生活质量、降低跌倒/再骨折率（分别为 12.5%和 4.88%）、降低压疮和关节僵硬发生率；但在 1 年内对功能恢复无影响。
考虑到当地环境，我们推荐 FLS 联合在线家庭护理，以经济、方便地监测患者，减少跌倒和再骨折，并提高护理和药物依从性。
