Highlights
- •Fragility fracture patients are at high risk of sustaining secondary fractures.
- •Safe and effective treatments having been available for almost three decades
- •Most fracture patients worldwide are not treated to prevent secondary fractures.
- •Fracture Liaison Services have been shown to circumvent the care gap.
- •Many free educational resources are available to support implementation of new Fracture Liaison Services.
Abstract
Over the course of the first half of the 21st century the age structure of the human
population will have undergone dramatic change, leading to what has been described
by the Fragility Fracture Network and the International Osteoporosis Foundation as
a new demographic era. In the absence of widespread implementation of systematic approaches
to chronic disease management, and prevention and treatment of osteoporosis and fragility
fractures in particular, fracture rates among older people will increase significantly
by mid-century. The purpose of this narrative review is to characterise the current
and projected burden of fragility fractures, evaluate current gaps in delivery of
best clinical practice, and summarise the literature on the Fracture Liaison Service
(FLS) model of care. A definition of FLS is provided, in addition to findings of systematic
reviews and associated meta-analyses conducted to assess the clinical and economic
benefits of FLS. Initiatives intended to enable benchmarking of the quality of care
provided by FLS are reviewed, including the flagship International Osteoporosis Foundation
Capture the Fracture® Programme and examples of national clinical standards for FLS
from several countries. The emergence of national clinical registries to facilitate
benchmarking against clinical standards is also considered. Finally, a precis is provided
of several global and regional initiatives that aim to support changes in healthcare
policy to provide funding, at scale, to support widespread implementation of FLS.
Keywords
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Article info
Publication history
Published online: July 13, 2022
Accepted:
July 2,
2022
Received in revised form:
June 27,
2022
Received:
April 11,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
