Implementing a fracture liaison service open model of care utilizing a cloud-based tool

Area of Science:

• Gerontology
• Public Health
• Health Services Research

Background:

• Osteoporotic fractures affect a significant portion of adults over 50, yet secondary prevention rates remain low.
• Less than a quarter of patients receive appropriate post-fracture care to prevent subsequent events.

Purpose of the Study:

• To implement and evaluate a Fracture Liaison Service (FLS) for secondary prevention of osteoporotic fractures.
• To assess the impact of a cloud-based tool in supporting FLS operations within open healthcare systems.

Main Methods:

• A pre-post study design was used to compare patient care before and after FLS implementation.
• Retrospective chart review and prospective data collection were conducted over six months post-fracture.
• Key metrics included bone mineral density testing, vitamin D assessment, and initiation of calcium/vitamin D and pharmacologic therapies.

Main Results:

• FLS implementation dramatically increased bone mineral density testing (21% to 93%) and vitamin D assessments (25% to 84%).
• Rates of calcium/vitamin D prescription rose from 36% to 93%, and pharmacologic osteoporosis treatment increased from 20% to 54%.
• All observed improvements were statistically significant (p < 0.001).

Conclusions:

• The Fracture Liaison Service model, supported by a cloud-based tool, effectively improved the assessment and treatment of patients with osteoporotic fractures.
• This care model demonstrates significant potential for enhancing secondary fracture prevention in open healthcare settings.
• Further research is needed to confirm the scalability and long-term fracture prevention efficacy of this FLS model.