Case Studies of Successful Services

The following examples of coordinator-based, post-fracture models of care demonstrate that a systematic approach to fragility fracture prevention has been successfully implemented in many countries, with structurally distinct healthcare systems.

Australia

Concord Repatriation General Hospital, Sydney

The Minimal Trauma Fracture Liaison (MTFL) service

• Targeted intervention reduces refracture rates in patients with incident non-vertebral osteoporotic fractures: a 4-year prospective controlled study. Lih A, Nandapalan H, Kim M, Yap C, Lee P, Ganda K, Seibel MJ. Osteoporos Int. 2011 Mar;22(3):849-858. PubMed ID 21107534
• Cost-effectiveness of the Concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study. Cooper MS, Palmer AJ, Seibel MJ. Osteoporos Int. 2012 Jan;23(1):97-107. PubMed ID 21953475

Canada

St. Michael’s Hospital, Toronto

The Osteoporosis Exemplary Care Program (OECP)

• Effective initiation of osteoporosis diagnosis and treatment for patients with a fragility fracture in an orthopaedic environment. Bogoch ER, Elliot-Gibson V, Beaton DE, Jamal SA, Josse RG, Murray TM. J Bone Joint Surg Am. 2006 Jan;88(1):25-34. PubMed ID 16391246
• A coordinator program in post-fracture osteoporosis management improves outcomes and saves costs. Sander B, Elliot-Gibson V, Beaton DE, Bogoch ER, Maetzel A. J Bone Joint Surg Am. 2008 Jun;90(6):1197-1205. PubMed ID 18519311

Singapore

Singapore hospitals

• OPTIMAL (Osteoporosis Patient Targeted and Integrated Management for Active Living). In: Capture the Fracture: A global campaign to break the fragility fracture cycle. Åkesson K, Mitchell PJ; for the International Osteoporosis Foundation. Page 15. 2012. PubMed ID 23615816

Netherlands

Academic Hospital of Maastricht

• The fracture and osteoporosis outpatient clinic: an effective strategy for improving implementation of an osteoporosis guideline. van Helden S, Cauberg E, Geusens P, Winkes B, van der Weijden T, Brink P. J Eval Clin Pract. 2007 Oct;13(5):801-805. PubMed ID 17824875

United Kingdom

Glasgow, Scotland

• The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. McLellan AR, Gallacher SJ, Fraser M, McQuillian C. Osteoporos Int. 2003 Dec;14(12):1028-1034. PubMed ID 14600804
• Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. McLellan AR, Wolowacz SE, Zimovetz EA, Beard SM, Lock S, McCrink L, Adekunle F, Roberts D. Osteoporos Int. 2011 Jul;22(7):2083-2098. PubMed ID 21607809

United States of America

Kaiser Healthy Bones Program

• Outcomes of an osteoporosis disease-management program managed by nurse practitioners. Greene D, Dell RM. J Am Acad Nurse Pract. 2010 Jun;22(6):326-329. PubMed ID 20536631
• Fracture prevention in Kaiser Permanente Southern California. Dell R. Osteoporosis Int. 2011 Aug;22 Suppl 3:457-460. PubMed ID 21847765