[Using a Fracture Liaison Service to Improve Care Outcomes in Patients With Fragility Hip Fracture]

The number of patients with fragility fractures in the orthopedic wards of our hospital has increased in recent years. Clinically, it has been observed that most of these patients lack awareness of osteoporosis and therefore do not receive timely post-operative assessment and treatment, placing them at a high risk of subsequent fractures. Accordingly, implementing osteoporosis screening and early interventions in this patient population is of critical importance.

A project was designed to implement a fracture liaison service model to enhance osteoporosis screening and pharmacological treatment rates.

Under this project, a multidisciplinary care pathway for patients with hip fragility fractures was established; shared decision-making was implemented; a high-calcium dietary education program was developed; a bone health education booklet was created; individualized rehabilitation programs were provided; discharge planning services were integrated; and a case management and follow-up system was enacted.

This project, implemented from June to December 2023, encompassed planning, implementation, and evaluation phases. Twelve patients were enrolled during the evaluation period (November-December 2023). Because of the limited sample size during this period, follow-up was extended through the effect maintenance period (January 2024-June 2025), yielding a total cohort of 319 patients, which was used as the basis for assessing intervention sustainability. The proportion of patients with hip fragility fractures who underwent bone mineral density testing within 8 weeks after surgery increased from 42.3% to 91.7%, with a sustained rate of 94.0% during the effect maintenance period. The proportion of patients receiving osteoporosis pharmacological treatment within 3 months after surgery increased from 39.5% to 100%, with a sustained rate of 97.8% during the effect maintenance period.

The multidisciplinary care pathway and case management system implemented through this project successfully enhanced disease awareness and self-care abilities among patients with fragility hip fracture. Moreover, beyond improving clinical outcomes, early diagnosis and timely treatment combined with rehabilitation and comprehensive education were shown to effectively establish a protective framework for preventing subsequent fractures.