Planning for action: Turkish National Council for Secondary Fracture Prevention Roundtable
As the 17th most populated country in the world, Turkey’s population has an average life expectancy of 77 years. The country’s population is ageing, with the number of people aged over 65 expected to rise from a current 9%, to 17% of the population in 2040. This highlights the urgent need to promote bone health and secondary fracture prevention, a challenge which has been taken on by the Turkish National Council for Secondary Fracture Prevention (NCSFP), under the auspices of the IOF Capture the Fracture® program. The NCSFP is comprised of leading experts and organizations in in the country.
At a meeting and Roundtable discussion held on October 11th, 2022, 19 participants addressed the priorities and challenges in post-fracture care and secondary fracture prevention in Turkey. The panel also discussed and continued planning for the NCSFP 2022-2034 national strategy and roadmap. The Roundtable was chaired by Dr Şansın Tüzün, with participants including Yeşim Gökçe Kutsal, Yeşim Kirazlı, Ülkü Akarırmak, Zeynep Cantürk, Dilşad Sindel, Dilek Gogas Yavuz, Lale Altan, Önder Aydıngöz, Pinar Borman, Gülistan Bahat Öztürk, Belgin Karaoğlan, Feyza Ünlü Özkan, Mazhar Tokgözoğlu, Gökhan Tuna Öztürk, Ziyneti Kocabıyık, and, from Capture the Fracture® Anastasia Soulié and Jake Wellian.
Professor Tüzün stated: “I would like to thank all those who participated at this very constructive meeting. We succeeded in pinpointing many of the current challenges facing secondary fracture prevention in Turkey and have more clearly defined a roadmap to advance progress. We hope to focus on key priorities that will help raise awareness of the need for Fracture Liaison Services (FLS) and which serve to generate interest and support for the implementation of these essential services throughout the country. At present Turkey counts 19 FLS, but many more are needed if we hope to provide better post-fracture care to reduce the number of secondary fractures in our older population. On the other hand, this rapid increase in the number of FLS has brought ‘sustainable performance’ to the agenda.”
The panel identified some common challenges in setting up an FLS, including, among others, the need for falls prevention services; more effective collaboration and communication between specialties and between FLSs and rehabilitation services; and challenges with monitoring and follow-up (which can also be attributed to the healthcare professionals’ lack of time to dedicate to osteoporosis patients). The discussion also addressed the below-average availability of DXA machines, and the need for improved training of technicians. Other topics raised included the need to improve awareness about the burden of osteoporosis and related fractures amongst primary care physicians. This is an important problem that also hampers effective collaboration between FLS physicians and primary care for effective identification and follow-up.
A key issue discussed was the need to improve dialogue between patients and their doctors, and the need for public awareness campaigns, including on the occasion of World Osteoporosis Day, to increase knowledge among the public and people at risk. Ms. Ziyneti Kocabıyık who is an experienced medical media editor, underlined the importance of social media campaigns, and interaction via media influencers. On the occasion of the National Council for Secondary Fracture Prevention (NCSFP) meeting, the 10 years of the IOF’s CTF programme, and the importance Secondary Fracture Prevention, these events were covered in the Turkish Press.
Looking forward, the NCSFP identified several key priorities to tackle the current challenges facing secondary fracture prevention. The NCSFP looks forward to working to together to encourage the establishment of FLSs through the ‘IOF Tour’ sessions, designating ambassadors to promote the adoption of tools to help exchange best practice, organizing educational sessions at national congresses and the development of a policy landscape assessment document to share with policy makers, the development of a benefit calculator for Turkey to prove the cost-effectiveness of FLS; and finally, increased focus on awareness campaigns to promote the need for FLS programs countrywide.
A sign of the momentum for secondary fracture prevention in Turkey was also the Capture the Fracture program FLS Café for Turkey. The FLS Café is an online meeting and exchange space where mentors and FLSs can share experiences and best practices. Organized by Prof. Şansın Tüzün, the FLS Café provided an informal forum for 18 attendees from different FLS to discuss and gain insights from experienced FLS mentors.