Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia.
Arch Osteoporos. 2024 Aug 3;19(1):70. doi: 10.1007/s11657-024-01427-x.
Fracture Liaison Service is a coordinator-based model effective in addressing the fragility fracture care gap. This study found that the service was feasible in Malaysia and could improve the delivery of secondary fracture prevention. Local adaptations and reactive responses addressed challenges, enhancing feasibility.
To assess the feasibility of a Fracture Liaison Service in Malaysia and to benchmark our service against the International Osteoporosis Foundation Best Practice Framework.
This feasibility study was conducted at a tertiary hospital in Malaysia from March 2021 to March 2022. Patients aged ≥ 50 years admitted with fragility fractures were recruited. Excluded were those with poor prognosis or transferred out from the hospital during admission. Patients were screened, assessed, and followed up at months 4 and 12 post-fracture presentations. Data was collected using Microsoft Excel and the REDCap database. The feasibility of the Fracture Liaison Service was evaluated using the typology of feasibility.
A total of 140 patients (female (93/140, 66.4%), median age 77 (IQR 72, 83), hip fractures (100/140, 65.8%)) were recruited into the Fracture Liaison Service. The recruitment rate was (140/215, 65.1%), as some patients were "missed" due to the COVID-19 pandemic. The completion rate was high (101/114, 88.6%). Among those indicated for antiosteoporosis medication, 82/100 (82%) were initiated on treatment. Various "Best Practice Standards," such as patient evaluation (140/140, 100%), fall prevention (130/140, 92.9%), and medication review standards (15/15, 100%) were high. Complicated referral pathways, inexperienced staff, lack of resources, and communication issues were some of the barriers identified while implementing the Fracture Liaison Service. Challenges were overcome by modifying the service workflow and coordinating with different departments.
The Fracture Liaison Service was found to be feasible in Malaysia. It demonstrated promise in improving bone health management; however, several changes were needed to adapt the service to suit our environment.
评估马来西亚骨折联络服务的可行性，并将我们的服务与国际骨质疏松基金会最佳实践框架进行基准比较。
本可行性研究于 2021 年 3 月至 2022 年 3 月在马来西亚的一家三级医院进行。招募年龄≥50 岁因脆性骨折入院的患者。排除标准为预后差或入院期间转院的患者。患者在骨折就诊后 4 个月和 12 个月进行筛查、评估和随访。使用 Microsoft Excel 和 REDCap 数据库收集数据。使用可行性的类型学评估骨折联络服务的可行性。
共纳入 140 例患者（女性 93/140，66.4%；中位年龄 77（IQR 72，83）；髋部骨折 100/140，65.8%）。骨折联络服务的入组率为（140/215，65.1%），因为一些患者因 COVID-19 大流行而“遗漏”。完成率很高（101/114，88.6%）。在需要抗骨质疏松药物治疗的患者中，82/100（82%）开始治疗。各种“最佳实践标准”，如患者评估（140/140，100%）、预防跌倒（130/140，92.9%）和药物审查标准（15/15，100%）均较高。在实施骨折联络服务时，发现复杂的转诊途径、缺乏经验的工作人员、资源匮乏和沟通问题等是一些障碍。通过修改服务工作流程并与不同部门协调，克服了这些挑战。
骨折联络服务在马来西亚被认为是可行的。它在改善骨骼健康管理方面表现出了希望；然而，为了使服务适应我们的环境，还需要进行一些更改。
