Developing fracture liaison service framework based on comparative analysis and scoping review

Area of Science:

• Orthopedics
• Public Health
• Health Services Research

Background:

• Fracture Liaison Services (FLS) are crucial for secondary fracture prevention.
• Existing FLS models vary, necessitating a standardized framework for effective implementation.
• Optimizing FLS is essential to reduce the burden of osteoporotic fractures.

Purpose of the Study:

• To conduct a comparative analysis and scoping review of 105 studies on Fracture Liaison Services (FLS).
• To develop a comprehensive FLS framework detailing essential implementation elements and perspectives.
• To provide a structured approach for real-world FLS interventions and improvements.

Main Methods:

• Comparative analysis of existing FLS models (e.g., Capture the Fracture, 5IQ, Ganda).
• Scoping review of literature from 2012-2022 across major scientific databases (PubMed, Web of Science, Scopus, ProQuest, IEEE).
• Development of a two-dimensional framework based on comparative analysis and scoping review findings.

Main Results:

• Identified four core FLS stages: patient identification, investigation, intervention, and continuity of care.
• Quality and information elements are integral across all FLS stages.
• A framework was created, mapping FLS components (Who, Where, When, What, How, Quality) against implementation stages.

Conclusions:

• The developed FLS framework can facilitate the adoption of effective implementation strategies.
• Further in-depth reviews of framework components are recommended to identify innovative approaches.
• The framework serves as a valuable tool for enhancing FLS effectiveness and optimizing fracture prevention.