Fracture Liaison Service

Geusens, Piet; Eisman, John A.; Singer, Andrea; Bergh, Joop van den

doi:10.1002/9781119266594.ch51

Cited by 6 publications

(3 citation statements)

References 44 publications

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“…Despite this, less than 50% of patients receive effective secondary fracture prevention after a fragility fracture[4]. This has led to national[5, 6] and international[7–11] initiatives to improve clinical services by implementing fracture liaison services (FLSs). Successful funding of a new FLS is usually influenced by the number of fractures it is expected to prevent in the first few years after an index fracture.…”

Section: Dear Editormentioning

confidence: 99%

Imminent fracture risk assessments in the UK FLS setting: implications and challenges

et al. 2019

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Section: Dear Editormentioning

confidence: 99%

Imminent fracture risk assessments in the UK FLS setting: implications and challenges

et al. 2019

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“…(7,8) This is supported by real-world evidence studies that have demonstrated clinically significant reductions in major fractures by anti-osteoporosis medication in patients with a recent fracture. (9) This has led to national (10,11) and international (12)(13)(14)(15)(16) initiatives to deliver effective secondary fracture prevention by implementing fracture liaison services (FLSs). FLSs are small groups of health care professionals who identify, assess, recommend treatment, and monitor adults who are recently diagnosed with a fragility fracture to reduce their risk of another fracture.…”

Section: Introductionmentioning

confidence: 99%

Expected Benefits and Budget Impact From a Microsimulation Model Support the Prioritization and Implementation of Fracture Liaison Services

Pinedo-Villanueva

Burn

Maronga

et al. 2020

Journal of Bone and Mineral Research

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Osteoporotic-related fractures cause significant patient disability, leading to a growing burden on health care systems. Effective secondary fracture prevention can be delivered by fracture liaison services (FLSs), but these are not available in most countries. A major barrier is insufficient policy prioritization, helped by the lack of economic assessments using national data and providing estimates of patient outcomes alongside health care resource use and cost impacts. The aim of this study was to develop an economic model to estimate the benefits and budget impact of FLSs and support their wider international implementation. Five interconnected stages were undertaken: establishment of a generic patient pathway; model design; identification of model inputs; internal validation and output generation; and scenario analyses. A generic patient pathway including FLS activities was built to underpin the economic model. A state-based microsimulation model was developed to estimate the impact of FLSs compared with current practice for men and women aged 50 years or older with a fragility fracture. The model provides estimates for health outcomes (subsequent fractures avoided and quality-adjusted life years [QALYs]), resource use, and health and social care costs, including those necessary for FLSs to operate, over 5 years. The model was run for an exemplar country the size of the United Kingdom. FLSs were estimated to lead to a reduction of 13,149 subsequent fractures and a gain of 11,709 QALYs. Hospital-bed days would be reduced by 120,989 and surgeries by 6455, while 3556 person-years of institutional social care would be avoided. Expected costs per QALY gained placed FLSs as highly cost-effective at £8258 per QALY gained over the first 5 years. Ten different scenarios were modeled using different configurations of FLSs. Further work to develop country-specific models is underway to delivery crucial national level data to inform the prioritization of FLSs by policy makers.

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“…What is the clinical consequence of the finding of an IF on an MRI in a patient with RMD with a painful foot, apart from symptomatic treatment for pain relief ? Many guidelines exclude forefoot fractures from secondary fracture prevention programs, 9,10 and there are no studies in which patients are enrolled based on fractures detected with MRI in which a treatment effect of an osteoporotic drug has been shown. However, the data from Buehring et al 1 show that these patients had common risk factors for fractures, such as smoking, low bone mineral density, a history of fractures, drug treatment for osteoporosis and fracture prevention, and use of methotrexate, which is known to be associated with stress fractures 11 ; all of these support the presence of underlying osteoporosis and increased fracture risk.…”

mentioning

confidence: 99%

High Frequency of Foot Insufficiency Fractures in Patients With Rheumatic Diseases Referred for Magnetic Resonance Imaging: What Is the Clinical Relevance?

Lems

Raterman²,

Geusens

2023

J Rheumatol

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We greatly appreciated the manuscript by Björn Buehring et al1about the high prevalence of foot insufficiency fractures (IFs) in patients with inflammatory rheumatic and musculoskeletal diseases (RMDs) who were referred for magnetic resonance imaging (MRI) because of foot pain, for several reasons. First, in using MRI, IFs were frequently diagnosed (7.5%) in referred patients with RMDs who had foot pain, and even more frequently in patients with inflammatory RMDs than in patients with noninflammatory RMDs (9.1% vs 4.1%, respectively).

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Fracture Liaison Service

Cited by 6 publications

References 44 publications

Imminent fracture risk assessments in the UK FLS setting: implications and challenges

Imminent fracture risk assessments in the UK FLS setting: implications and challenges

Expected Benefits and Budget Impact From a Microsimulation Model Support the Prioritization and Implementation of Fracture Liaison Services

High Frequency of Foot Insufficiency Fractures in Patients With Rheumatic Diseases Referred for Magnetic Resonance Imaging: What Is the Clinical Relevance?

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