Implementation of an in-patient hip fracture liaison services to improve initiation of osteoporosis medication use within 1-year of hip fracture: a population-based time series analysis using the RE-AIM framework

Beaupré, Lauren A; Moradi, F; Khong, Hoa; Smith, Christopher; Evens, L; Hanson, Heather; Juby, Angela; Kivi, Paul; Majumdar, Sumit R.; Team, STOP-Fracture

doi:10.1007/s11657-020-00751-2

Cited by 9 publications

(8 citation statements)

References 29 publications

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“…After different nursing methods, the WHOQOL-BREF scores of the group R patients were greatly higher compared with the scores of group C, with statistical differences (89.64 points vs. 61.45 points; P < 0.05). is indicates that the rapid rehabilitation nursing intervention can improve the QOL of patients effectively treated with fracture surgery [17][18][19].…”

Section: Comparison On the Whoqol-bref Scorementioning

confidence: 99%

Unsupervised Data Mining and Effect of Fast Rehabilitation Nursing Intervention in Fracture Surgery

Zhou

2022

Journal of Healthcare Engineering

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At present, the most commonly used surgical treatment for fractures caused by external force injury is clinical, and unsupervised data mining is more advantageous in the face of the unknown format of perioperative network data. Therefore, this research aims to explore the application effect of unsupervised data mining in the concept of rapid rehabilitation nursing intervention after fracture surgery. 80 patients who underwent fracture surgery in the Department of Orthopedics of XXX Hospital were determined as the subjects, who were rolled into a research group (group R, 40 cases) and a control group (group C, 40 cases) by drawing lots. An unsupervised data mining algorithm based on unsupervised data mining for support vector machines (VDMSVMs) was proposed and applied to two groups of patients undergoing perioperative fracture surgery with the rapid rehabilitation nursing intervention and basic routine nursing. The results showed that the number of important features selected by the VDMSVM algorithm (5) was obviously more than that of the compressed edge fragment sampling (CEFS) algorithm (1) and the multicorrelation forward searching (MCFS) algorithm (2) ( P < 0.05 ). The number of noise features screened by the VDMSVM algorithm (3) was much less in contrast to that of the CEFS algorithm and the MCFS algorithm, which was 8 and 10, respectively (P < 0.05). The Visual Analogue Scale (VAS) scores of the fracture site at the 4th, 8th, 12th, and 16th hour after surgery in group R were all lower than the scores in group C ( P < 0.05 ). The length of hospital stay (LoHS) in group R was greatly shorter than that in group C ( P < 0.05 ). After different nursing methods, the World Health Organization Quality of Life (WHOQOL-BREF) score of patients in group R (89.64 points) was greatly higher than the score in group C (61.45 points) ( P < 0.05 ). The nursing satisfaction score of group R was 92.35 ± 3.65 points, and that in group C was 2.14 ± 1.25 points, respectively ( P < 0.05 ). The test results verified the effectiveness of the feature selection of the VDMSVM algorithm. The rapid rehabilitation nursing intervention was conductive to reducing the postoperative pain of fracture patients, shortening the LoHS of patients, improving the quality of life (QOL) of fracture surgery patients, and increasing the patient’s satisfaction with nursing.

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Section: Comparison On the Whoqol-bref Scorementioning

confidence: 99%

Unsupervised Data Mining and Effect of Fast Rehabilitation Nursing Intervention in Fracture Surgery

Zhou

2022

Journal of Healthcare Engineering

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“…The majority of the studies were conducted in Australia ( n = 10 [ 27 , 36 , 43 , 59 , 87 – 90 , 94 , 95 ]), Canada ( n = 17 [ 25 , 28 , 34 , 35 , 38 , 60 – 70 , 102 ]), USA ( n = 18 [ 23 , 29 , 31 , 32 , 37 , 46 , 77 – 86 , 92 , 93 ]), and European Union ( n = 19 [ 24 , 26 , 33 , 40 , 42 , 44 , 45 , 48 – 50 , 76 , 91 , 96 – 98 , 100 , 101 , 103 , 105 ]). Five studies were carried out in the Asian continent (Israel, Japan, Thailand, and Lebanon), four publications were from the UK, three studies were performed in Ireland and one in New Zealand.…”

Section: Resultsmentioning

confidence: 99%

“…Studies were conducted using information from hospital or community-based hospitals or general practitioners [ 23 – 26 , 28 – 34 , 39 – 45 , 48 – 50 , 52 , 59 – 61 , 63 , 66 – 71 , 73 , 75 – 79 , 81 – 83 , 86 , 91 , 93 – 95 , 97 – 101 , 103 – 105 ], tertiary referral hospital or centers [ 27 , 36 , 47 , 88 – 90 ], or both [ 87 ], community pharmacies [ 64 ], administrative data [ 35 , 37 , 46 , 51 , 65 , 70 , 84 , 85 , 96 ] or specialized clinics or centers [ 62 , 72 , 74 , 80 , 92 , 102 ]. In general, patients had low trauma fracture, specifically hip [ 23 , 24 , 27 , 31 , 32 , 34 , 35 , 40 – 42 , 44 , 45 , 47 , 49 , 51 , 52 ], upper extremity [ 28 ], and vertebral [ …”

Section: Resultsmentioning

confidence: 99%

The integrated structure of care: evidence for the efficacy of models of clinical governance in the prevention of fragility fractures after recent sentinel fracture after the age of 50 years

Cianferotti,

Porcu,

Ronco

et al. 2023

Arch Osteoporos

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Summary Randomized clinical trials and observational studies on the implementation of clinical governance models, in patients who had experienced a fragility fracture, were examined. Literature was systematically reviewed and summarized by a panel of experts who formulated recommendations for the Italian guideline. Purpose After experiencing a fracture, several strategies may be adopted to reduce the risk of recurrent fragility fractures and associated morbidity and mortality. Clinical governance models, such as the fracture liaison service (FLS), have been introduced for the identification, treatment, and monitoring of patients with secondary fragility fractures. A systematic review was conducted to evaluate the association between multidisciplinary care systems and several outcomes in patients with a fragility fracture in the context of the development of the Italian Guidelines. Methods PubMed, Embase, and the Cochrane Library were investigated up to December 2020 to update the search of the Scottish Intercollegiate Guidelines Network. Randomized clinical trials (RCTs) and observational studies that analyzed clinical governance models in patients who had experienced a fragility fracture were eligible. Three authors independently extracted data and appraised the risk of bias in the included studies. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Effect sizes were pooled in a meta-analysis using random-effects models. Primary outcomes were bone mineral density values, antiosteoporotic therapy initiation, adherence to antiosteoporotic medications, subsequent fracture, and mortality risk, while secondary outcomes were quality of life and physical performance. Results Fifteen RCTs and 62 observational studies, ranging from very low to low quality for bone mineral density values, antiosteoporotic initiation, adherence to antiosteoporotic medications, subsequent fracture, mortality, met our inclusion criteria. The implementation of clinical governance models compared to their pre-implementation or standard care/non-attenders significantly improved BMD testing rate, and increased the number of patients who initiated antiosteoporotic therapy and enhanced their adherence to the medications. Moreover, the treatment by clinical governance model respect to standard care/non-attenders significantly reduced the risk of subsequent fracture and mortality. The integrated structure of care enhanced the quality of life and physical function among patients with fragility fractures. Conclusions Based on our findings, clinicians should promote the management of patients experiencing a fragility fracture through structured and integrated models of care. The task force has formulated appropriate recommendations on the implementation of multidisciplinary care systems in patients with, or at risk of, fragility fractures.

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“…This is pertinent given the proportion of patients we observed with a subsequent hip fracture within a year of FLS identification. Finally, at the patient level, early initiation of treatment and support for adherence are required [44]. Adherence is poor with AOM therapy and improving adherence remains a substantial challenge for FLSs across the globe [45].…”

Section: Discussionmentioning

confidence: 99%

Subsequent hip fractures in patients identified by a Fracture Liaison Service (FLS) in England and Wales – linkage of the national FLS and Hip Fracture databases

Javaid

Mohsin

Johansen

et al. 2022

Preprint

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Fracture Liaison Services (FLSs) are recommended healthcare models to deliver secondary fracture prevention and reduce the risk of subsequent fractures. Several studies have demonstrated the cost and clinical effectiveness of FLSs, but there is little real-world data on the impact of FLSs on subsequent hip fracture rates. A cohort of 50,214 patients from the national FLS database with an index fracture of the hip, spine, or other site England and Wales in 2017 was linked to the National Hip Fracture Database from 2017 to 2020 to identify those patients who went on to have a subsequent hip fracture. One in twenty (5.1%) of the 9,888 people in whom the index fracture was at the hip went on to suffer a second hip fracture within 3-4 years, despite receiving the support of an FLS. The risk of hip fracture was similar (4.7%) if the index fracture was at the spine, but lower at other sites (2.8%, p<0.001) and the interval shortest after an index hip fracture (1.1 years (0.4,2.0) p<0.001). The proportion of patients with a subsequent hip fracture was not lower by types of anti-osteoporotic medication. This work highlights the need for alternative anti-osteoporotic management strategies to rapidly decrease the risk of subsequent hip fractures for people seen by an FLS setting with levels of risk that are even higher for patients in areas which are still not served by an FLS.

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Implementation of an in-patient hip fracture liaison services to improve initiation of osteoporosis medication use within 1-year of hip fracture: a population-based time series analysis using the RE-AIM framework

Cited by 9 publications

References 29 publications

Unsupervised Data Mining and Effect of Fast Rehabilitation Nursing Intervention in Fracture Surgery

Unsupervised Data Mining and Effect of Fast Rehabilitation Nursing Intervention in Fracture Surgery

The integrated structure of care: evidence for the efficacy of models of clinical governance in the prevention of fragility fractures after recent sentinel fracture after the age of 50 years

Subsequent hip fractures in patients identified by a Fracture Liaison Service (FLS) in England and Wales – linkage of the national FLS and Hip Fracture databases

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