Best Practice Framework of Fracture Liaison Services in Spain and their coordination with Primary Care
Open Access
- 25 April 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Archives of Osteoporosis
- Vol. 15 (1), 1-7
- https://doi.org/10.1007/s11657-020-0693-z
Abstract
Summary The coordination of Fracture Liaison Services (FLS) with Primary Care (PC) is necessary for the continuity of care of patients with fragility fractures. This study proposes a Best Practice Framework (BPF) and performance indicators for the implementation and follow-up of FLS-PC coordination in clinical practice in Spain. Purpose To develop a BPF for the coordination of FLS with PC in Spain and to improve the continuity of care for patients with fragility fractures. Methods A Steering Committee selected experts from seven Spanish FLS and related PC doctors and nurses to participate in a best practice workshop. Selection criteria were an active FLS with an identified champion and prior contact with PC centres linked to the hospital. The main aim of the workshop was to review current FLS practices in Spain and their integration with PC. A BPF document with processes, tools, roles, and metrics was then generated. Results Spanish FLS consists of a multidisciplinary team of physicians/nurses but with low participation of other professionals and PC staff. Evaluation and treatment strategies are widely variable. Four desired standards were agreed upon: (1) Effective channels for FLS-PC communication; (2) minimum contents of an FLS clinical report and its delivery to PC; (3) adherence monitoring 3 months after FLS baseline visit; and (4) follow-up by PC. Proposed key performance indicators are (a) number of FLS-PC communications, including consensus protocols; (b) confirmation FLS report received by PC; (c) medical/nursing PC appointment after FLS report received; and (d) number of training sessions in PC. Conclusions The BPF provides a comprehensive approach for FLS-PC coordination in Spain, to promote the continuity of care in patients with fragility fractures and improve secondary prevention. The implementation of BPF recommendations and performance indicator tracking will benchmark best FLS practices in the future.Keywords
This publication has 32 references indexed in Scilit:
- Capture the Fracture: a Best Practice Framework and global campaign to break the fragility fracture cycleOsteoporosis International, 2013
- Estimación del riesgo de fractura osteoporótica a los 10 años para la población españolaMedicina Clinica, 2013
- Making the first fracture the last fracture: ASBMR task force report on secondary fracture preventionJournal of Bone and Mineral Research, 2012
- Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysisOsteoporosis International, 2012
- The activity of a Spanish bone densitometry unit revisited under the point of view of FRAXReumatología Clínica (English Edition), 2012
- Value of routine monitoring of bone mineral density after starting bisphosphonate treatment: secondary analysis of trial dataBMJ, 2009
- Redesigning the care of fragility fracture patients to improve osteoporosis management: A health care improvement projectArthritis Care & Research, 2005
- The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fractureOsteoporosis International, 2003
- Hip fracture patients are not treated for osteoporosis: A call to actionArthritis Care & Research, 2002
- Patients with Prior Fractures Have an Increased Risk of Future Fractures: A Summary of the Literature and Statistical SynthesisJournal of Bone and Mineral Research, 2000