One type A service with a valid control group showed a significant decrease in re-fractures .
Types A and B services were cost-effective , although definition of cost-effectiveness varied between studies .
Fully coordinated , intensive models of care for secondary fracture prevention are more effective in improving patient outcomes than approaches involving alerts and /or education only
Most people presenting with incident osteoporotic fractures are neither assessed nor treated for osteoporosis to reduce their risk of further fractures , despite the availability of effective treatments .
We evaluated the effectiveness of published models of care for the secondary prevention of osteoporotic fractures .
Implementation of osteoporosis guidelines: a survey of five large fracture liaison services in the Netherlands
Summary Implementation of case findings according to guidelines for osteoporosis in fracture patients presenting at a Fracture Liaison Service ( FLS ) was evaluated . Despite one guideline , all FLSs differed in the performance of patient selection and prevalence of clinical risk factors ( CRFs ) indicating the need for more concrete and st and ardised guidelines . Introduction The aim of the study was to evaluate the implementation of case findings according to guidelines for osteoporosis in fracture patients presenting at FLSs in the Netherl and s. Methods Five FLSs were contacted to participate in this prospect i ve study . Patients older than 50 years with a recent clinical fracture who were able and were willing to participate in fracture risk evaluation were included . Performance was evaluated by criteria for patient recruitment , patient characteristics , nurse time , evaluated clinical risk factors ( CRFs ) , bone mineral density ( BMD ) and laboratory testing and results of CRFs and BMD are presented . Differences between FLSs were analysed for performance ( by chi-square and Student ’s t test ) and for prevalence of CRFs ( by relative risks ( RR ) ) . Results All FLSs had a dedicated nurse spending 0.9 to 1.7 h per patient . During 39 to 58 months follow-up , 7,199 patients were evaluated ( 15 to 47 patients /centre/month ; mean age , 67 years ; 77 % women ) . Major differences were found between FLSs in the performance of patient recruitment , evaluation of CRFs , BMD and laboratory testing , varying between 0 % and 100 % . The prevalence of CRFs and osteoporosis varied significantly between FLSs ( RR between 1.7 and 37.0 , depending on the risk factor ) . Conclusion All five participating FLSs with a dedicated fracture nurse differed in the performance of patient selection , CRFs and in the prevalence of CRFs , indicating the need for more concrete and st and ardised guidelines to organise evaluation of patients at the time of fracture in daily practice
One type A service with a valid control group showed a significant decrease in re-fractures .
Types A and B services were cost-effective , although definition of cost-effectiveness varied between studies .
Fully coordinated , intensive models of care for secondary fracture prevention are more effective in improving patient outcomes than approaches involving alerts and /or education only
Most people presenting with incident osteoporotic fractures are neither assessed nor treated for osteoporosis to reduce their risk of further fractures , despite the availability of effective treatments .
We evaluated the effectiveness of published models of care for the secondary prevention of osteoporotic fractures .