Operative secondary prevention of fragility fractures: national clinical standards for fracture liaison service in Egypt—an initiative by the Egyptian Academy of Bone Health
Tóm tắt
Despite a broad spectrum of effective anti-osteoporosis therapies and a growing number of older adults worldwide, the number of people receiving appropriate secondary fracture prevention is not yet optimum or achieved its expected target, i.e., avoiding refracture. To close this gap in the patients’ care, and in concordance with the International Osteoporosis Foundation (IOF) as well as international organizations recommendations, the Egyptian Academy of Bone Health and Metabolic Bone Diseases has launched specialised healthcare system for fracture liaison services (FLSs). FLS is a small team of healthcare professionals who identify, investigate, initiate therapy and arrange for follow-up plan over time, for people aged 50 and above presenting with a fragility fracture. Such comprehensive service requires operative clinical standards which would help to standardise the service across the different centres to become effective and sustainable. An estimated 71.8% of the Egyptian population currently have access to a local FLSs. This article aims at setting up evidence-based standards of post-fracture care and provide the necessary index for efficient implementation of secondary fracture prevention in the different FLS centres in Egypt. The Egyptian FLS clinical standards agree with the international protocols and are an effective approach to target interventions to the properly identified patients at risk. The Egyptian model has identified 19 key performance indicators to measure the effectiveness of fracture liaison services and guide quality improvement.
Tài liệu tham khảo
Mauck KF, Clarke BL (2006) Diagnosis, Screening, Prevention, and Treatment of Osteoporosis. Mayo Clin Proc 81(5):662–672
Bonafede M, Shi N, Barron R, Li X, Crittenden DB, Chandler D (2016) Predicting imminent risk for fracture in patients aged 50 or older with osteoporosis using US claims data. Arch Osteoporos 11:26
Kanis JA, Cooper C, Rizzoli R, Abrahamsen B, Al-Daghri NM, Brandi ML, Cannata-Andia J, Cortet B, Dimai HP, Ferrari S, Hadji P, Harvey NC, Kraenzlin M, Kurth A, McCloskey E, Minisola S, Thomas T, Reginster JY (2017) European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int 28:2023–2034
Van Geel TACM, van Helden S, Geusens PP, Winkens B, Dinant GJ (2009) Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis 68:99–102
Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, Chrischilles EA, Pavlik CE, Wallace RB, Ohsfeldt RL, Jones MP, Rosenthal GE, Wolinsky FD (2009) The aftermath of hip fracture: discharge placement, functional status change, and mortality. Am J Epidemiol 170:1290–1299
Leibsen CL, Tosteson AN, Gabriel SE, Ransom JE, Melton LJ (2002) Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriat Soc 50:1644–1650
International Osteoporosis Foundation. Capture the Fracture Report 2012. https://www.iofbonehealth.org/capture-fracturereport-2012. Accessed 21 November 2021
Bliuc D, Alarkawi D, Nguyen TV, Eisman JA, Center JR (2015) Risk of subsequent fractures and mortality in elderly women and men with fragility fractures with and without osteoporotic bone density: the Dubbo osteoporosis epidemiology study. J Bone Miner Res 30:637–646
Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR (1999) Vertebral fractures and mortality in older women: a prospective study. Study of osteoporotic fractures research group. Arch Intern Med 159:1215–1220
Katsoulis M, Benetou V, Karapetyan T, Feskanich D, Grodstein F, Pettersson-Kymmer U, Eriksson S, Wilsgaard T, Jørgensen L, Ahmed LA, Schöttker B, Brenner H, Bellavia A, Wolk A, Kubinova R, Stegeman B, Bobak M, Boffetta P, Trichopoulou A (2017) Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project. J Intern Med 281:300–310
Klop C, van Staa T, Cooper C, Harvey N, de Vries F (2017) The epidemiology of mortality after fracture in England: variation by age, sex, time, geographic location, and ethnicity. Osteoporos Int 28:161–168
von Friesendorff M, McGuigan FE, Wizert A, Rogmark C, Holmberg AH, Woolf AD, Akesson K (2016) Hip fracture, mortality risk, and cause of death over two decades. Osteoporos Int 27:2945–2953
Van Staa TP, Dennison EM, Leufkens HGM, Cooper C (2001) Epidemiology of fractures in England and Wales. Bone 29(6):517–522
Gheita T, Hammam N (2018) Epidemiology and awareness of osteoporosis: a viewpoint from the Middle East and North Africa. Int. J. Clin. Rheumatol 13(3):134–147
El-Kawaly WH, Amer MS, Hamza SA, Arif ER (2016) Fracture risk assessment in geriatric homes in Egypt. Indian J Med Res Pharmaceutical Sci 3(10):4–14
El Miedany Y, Abu-Zaid MH, El Gaafary M et al (2021) Egyptian consensus on treat-totarget approach for osteoporosis: a clinical practice guideline from the Egyptian Academy of bone health and metabolic bone diseases. Egypt Rheumatol Rehabil 48:5
Delmas PD, van de Langerijt L, Watts NB et al (2005) Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res 20(4):557–563
McLellan AR, Gallacher SJ, Fraser M, McQuillian C (2003) The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 14(12):1028–1034
Chan T, de Lusignan S, Cooper A, Elliott M (2015) Improving Osteoporosis Management in Primary Care: An Audit of the Impact of a Community Based Fracture Liaison Nurse. PLoS One 10(8):e0132146
Dell R (2011) Fracture prevention in Kaiser Permanente Southern California. Osteoporos Int 22 Suppl 3:457–460
International Osteoporosis Foundation. Map of best practice. http://www.capturethefracture.org/map-of-best-practice. (Accessed 21th November 2021)
Akesson K, Marsh D, Mitchell PJ et al (2013) Capture the Fracture: a Best Practice Framework and global campaign to break the fragility fracture cycle. Osteoporos Int 24(8):2135–2152
Javaid MK, Kyer C, Mitchell PJ et al (2015) Effective secondary fracture prevention: implementation of a global benchmarking of clinical quality using the IOF Capture the Fracture(R) Best Practice Framework tool. Osteoporos Int 26(11):2573–2578
Gittoes N, McLellan AR, Cooper A et al (2019) Effective Secondary Prevention of Fragility Fractures: Clinical Standards for Fracture Liaison Services. National Osteoporosis Society, Camerton https://theros.org.uk/media/1eubz33w/ros-clinical-standards-for-fracture-liaisonservices-august-2019.pdf
Javaid MK, Sami A, Lems W, Mitchell P, Thomas T, Singer A, Speerin R, Fujita M, Pierroz DD, Akesson K, Halbout P, Ferrari S, Cooper C (2020) A patient-level key performance indicator set to measure the effectiveness of fracture liaison services and guide quality improvement: a position paper of the IOF Capture the Fracture Working Group, National Osteoporosis Foundation and Fragility Fracture Network. Osteoporos Int 31(7):1193–1204
Elliot-Gibson V, Bogoch ER, Jamal SA, Beaton DE (2004) Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int 15:767–778
Hoang-Kim A, Schemitsch E, Sale JE, Beaton D, Warmington K, Kulkarni AV, Reeves S (2014) Understanding osteoporosis and fractures: an introduction to the use of qualitative research. Arch Orthop Trauma Surg 134(2):207–217
Vaculik J, Stepan JJ, Dungl P, Majerní M, Alexander Č (2017) Secondary fracture prevention in hip fracture patients requires cooperation from general practitioners. Arch Osteoporos 12(1):49
Harrington JT, Broy SB, Derosa AM, Licata AA, Shewmon DA (2002) Hip fracture patients are not treated for osteoporosis: a call to action. Arthritis Rheum 47:651–654
Osteoporosis Canada (2014) Quality Standards for Fracture Liaison Services in Canada. Osteoporosis Canada, Toronto https://fls.osteoporosis.ca/fls-tools-and-resources/
British Orthopaedic Association, National Osteoporosis Society. BOAST 9: Fracture Liaison Services. London 2014.
International Osteoporosis Foundation. Capture the Fracture® Programme website. http://www.capturethefracture.org/. Accessed 23 November 2021.
Erhan B, Ataker Y (2020) Rehabilitation of Patients With Osteoporotic Fractures. J Clin Densitom 23(4):534–538