Systematic reviews have shown that individuals who have suffered a fragility fracture are at significantly increased risk of suffering second and subsequent fractures, as compared to their peers who have not broken a bone. Also, a significant proportion of individuals who break their hip have suffered prior fragility fractures.
In light of this, reliable delivery of secondary fracture prevention – addressing both osteoporosis and falls risk reduction – is a vital component of post-fracture care for all older fragility fracture sufferers. Tragically, worldwide, the majority of these patients do not receive the secondary preventive care they need, and so are left needlessly at high risk of suffering future fractures.
Major international initiatives have been developed over the last decade with the intention of eliminating the secondary prevention care gap, which include:
- International Osteoporosis Foundation: The Capture the Fracture ® Campaign is leading the global drive for implementation of clinically effective and cost-effective systems of care that have come to be known as Fracture Liaison Services (FLS).
- National Bone Health Alliance (U.S.A.): The Fracture Prevention CENTRAL website and associated webinar program and 2Million2Many Campaign are components of the NBHA’s ‘20/20 Vision’ which aims to reduce the incidence of fragility fractures by 20% in the United States by year 2020.
- Osteoporosis Canada: The Make the FIRST break the LAST with Fracture Liaison Services initiative calls for all jurisdictions in Canada to implement an FLS by 2015.
Supported by these excellent initiatives, and others like them – from New Zealand to Singapore to London to Boston to Rio to Los Angeles – implementation of FLS is gaining momentum.
The links below provide a summary of why secondary fracture prevention is so crucial, how the FLS model complements orthopaedic-geriatric co-care models, patients’ understanding of fracture risk and links to the major initiatives being led by other organisations. We strongly encourage you to visit the websites of these initiatives and read their campaign publications, as a tremendous suite of resources is available to help you to eliminate the secondary prevention care gap.
- Rationale for secondary fracture prevention
- Orthopaedic-geriatric co-care models and Fracture Liaison Services
- Patients’ knowledge and understanding of fracture risk
- Falls prevention
- Links to major secondary prevention initiatives