Implementation of a primary care-based fracture liaison service with information technology support to improve...

This study evaluated the effectiveness and acceptability of implementing a Fracture Liaison Service (FLS) and Information Technology (IT) platform into Australian general practices to improve osteoporosis management.

Fracture Liaison Coordinators (FLCs) supported participating general practices in case-finding, and bone health education and assessment in at-risk individuals over 18 months from June 2022 to December 2023. Using the Compass IT platform, FLCs generated individualised patient management plans aligned with clinical guidelines for discussion between the general practitioner (GP) and patient. Initiation of bone protective medication occurred, as appropriate. Post-intervention surveys evaluated the effectiveness and acceptability of the intervention by participating GPs and patients.

Overall, 1299 individuals and 66 GPs across 51 general practice sites participated in the study, an enrolment rate of 3.1% for invited GPs (n = 66/2118) and 4.7% for invited clinic sites (n = 51/1083). Three hundred and sixteen patients were newly identified with osteoporosis based on bone mineral density (BMD) assessment by dual energy x-ray absorptiometry (DXA) scan, spinal x-ray, or prior history of fragility fracture, who were not on treatment. Of these, 141 patients commenced osteoporosis treatment, a treatment rate of 45% (n = 141/316). In post-intervention evaluation surveys, 89% of participating GPs and 92% of patient respondents found the FLS service valuable and acceptable.

This real-world study of a general practice-based FLS supported by a disease-specific IT platform improved osteoporosis diagnosis and management and was acceptable to both GPs and patients.

Osteoporosis is under-diagnosed and under-treated in primary care. Our study found that implementing an integrated Fracture Liaison Service (FLS) and Information Technology (IT) platform into Australian general practices improved osteoporosis diagnosis and management and was acceptable to both general practitioners and patients. Wider implementation could complement and enhance hospital-based FLSs to improve bone health management in the community.