NDORMS, Oxford, UK.
International Osteoporosis Foundation Latin America Office, Buenos Aires, Argentina.
Osteoporos Int. 2023 Nov;34(11):1881-1891. doi: 10.1007/s00198-023-06742-6. Epub 2023 Jul 7.
Realising the benefits of systematic secondary fracture prevention requires supporting local sites to get started and becoming effective. We here describe the development, implementation and impact of a regional fracture liaison service (FLS) mentorship programme in Latin America that led to 64 FLS getting started and coverage of 17,205 patients.
Despite treatments and service models to deliver effective secondary fracture prevention, most patients are left untreated after a fragility fracture. To improve the capability to get FLS started and more effective, we describe the development, implementation and evaluation of an international programme to develop national communities of FLS mentors as part of the Capture the Fracture Partnership in Latin America.
The IOF regional team and the University of Oxford developed the curriculum and associated resources for training mentors in setting up FLS, service improvement and mentorship. Mentors were selected during a preparatory meeting, trained using live online sessions followed by regular mentor-led post-training meetings. The programme was evaluated using a pre-training needs assessment and post-training evaluation based on Moore's outcomes.
The mentorship programme was initiated in Mexico, Brazil, Colombia and Argentina. The mentors were multidisciplinary, including orthopaedic surgery, rehabilitation, rheumatology, endocrinology, geriatrics, gynaecology and internal medicine. There was 100% participation in training sessions and reported satisfaction with the training. Since the initiation of the training programme, 22 FLS have been set up in Mexico, 30 in Brazil, 3 in Colombia and 9 in Argentina, in comparison with two in Chile and none in any other LATAM countries that were not involved in the mentorship programme. This equates to approximately 17,025 additional patients identified from 2019 to 2021 after initiation of mentorship. The mentors have engaged with 58 FLS for service development. Post-training activities include two published national best practice guidelines and other country-specific resources for FLS in the local language.
Despite the COVID pandemic, the mentorship pillar of the Capture the Fracture Partnership has developed a community of FLS mentors with measurable improvement in national FLS provision. The programme is a potentially scalable platform to develop communities of mentors in other countries.
实现系统性二次骨折预防的益处需要支持当地站点启动并提高效率。我们在此描述了在拉丁美洲开发、实施和评估区域骨折联络服务 (FLS) 指导计划的情况，该计划导致 64 个 FLS 启动并覆盖了 17,205 名患者。
尽管有治疗和服务模式来提供有效的二次骨折预防，但大多数患者在脆性骨折后仍未得到治疗。为了提高 FLS 启动和更有效的能力，我们描述了开发国际 FLS 导师社区的发展、实施和评估，这是拉丁美洲骨折捕获伙伴关系的一部分。
IOF 区域团队和牛津大学开发了培训导师在建立 FLS、服务改进和指导方面的课程和相关资源。在筹备会议期间选择导师，使用在线实时课程进行培训，然后定期由导师主导培训后会议。该计划使用基于 Moore 结果的培训前需求评估和培训后评估进行评估。
指导计划在墨西哥、巴西、哥伦比亚和阿根廷启动。导师是多学科的，包括矫形外科、康复、风湿病学、内分泌学、老年病学、妇科和内科。培训课程的参与率为 100%，并对培训表示满意。自培训计划启动以来，在墨西哥设立了 22 个 FLS，巴西设立了 30 个，哥伦比亚设立了 3 个，阿根廷设立了 9 个，而智利设立了 2 个，拉丁美洲其他没有参与指导计划的国家则没有设立。这相当于在 2019 年至 2021 年指导计划启动后，额外确定了大约 17,025 名患者。导师已经与 58 个 FLS 合作开展服务开发。培训后的活动包括在当地语言中发布的两份国家最佳实践指南和其他特定国家的 FLS 资源。
尽管受到 COVID 大流行的影响，但骨折捕获伙伴关系的指导支柱已经发展了一个 FLS 导师社区，在国家 FLS 提供方面取得了可衡量的改善。该计划是一个潜在的可扩展平台，可以在其他国家发展导师社区。
