Fracture prevention service to bridge the osteoporosis care gap

Carmelinda Ruggiero,1 Elena Zampi,1 Giuseppe Rinonapoli,2 Marta Baroni,1 Rocco Serra,1 Elisa Zengarini,1 Gregorio Baglioni,3 Giuliana Duranti,3 Sara Ercolani,1 Francesco Conti,4 Auro Caraffa,2 Patrizia Mecocci,1 Maria Luisa Brandi5 1Geriatric Unit, University of Perugia, Hospital S Maria della Mise...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ruggiero C, Zampi E, Rinonapoli G, Baroni M, Serra R, Zengarini E, Baglioni G, Duranti G, Ercolani S, Conti F, Caraffa A, Mecocci P, Brandi ML
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	osteoporosis secondary prevention hip fracture Fracture liaison service model of care Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/715ffc3fc99f4c91a8255c2fda8f0809
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:715ffc3fc99f4c91a8255c2fda8f0809
record_format	dspace
spelling	oai:doaj.org-article:715ffc3fc99f4c91a8255c2fda8f08092021-12-02T07:33:30ZFracture prevention service to bridge the osteoporosis care gap1178-1998https://doaj.org/article/715ffc3fc99f4c91a8255c2fda8f08092015-06-01T00:00:00Zhttps://www.dovepress.com/fracture-prevention-service-to-bridge-the-osteoporosis-care-gap-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Carmelinda Ruggiero,1 Elena Zampi,1 Giuseppe Rinonapoli,2 Marta Baroni,1 Rocco Serra,1 Elisa Zengarini,1 Gregorio Baglioni,3 Giuliana Duranti,3 Sara Ercolani,1 Francesco Conti,4 Auro Caraffa,2 Patrizia Mecocci,1 Maria Luisa Brandi5 1Geriatric Unit, University of Perugia, Hospital S Maria della Misericordia, 2Orthopedic and Traumatologic Unit, University of Perugia, Hospital S Maria della Misericordia, 3Primary Care Physicians, SIMG Umbria, Perugia, 4Department of Clinical and Molecular Medicine, Sapienza University of Rome, AO Sant’Andrea Hospital, Rome, 5Department of Internal Medicine, University of Florence, Florence, Italy Background: A care gap exists between the health care needs of older persons with fragility fractures and the therapeutic answers they receive. The Fracture Prevention Service (FPS), a tailored in-hospital model of care, may effectively bridge the osteoporosis care gap for hip-fractured older persons. The purpose of this study was to evaluate the efficacy of the FPS in targeting persons at high risk of future fracture and to improve their adherence to treatment.Methods: This was a prospective observational study conducted in a teaching hospital with traumatology and geriatric units, and had a pre-intervention and post-intervention phase. The records of 172 participants were evaluated in the pre-intervention phase, while data from 210 participants were gathered in the post-intervention phase. All participants underwent telephone follow-up at 12 months after hospital discharge. The participants were patients aged ≥65 years admitted to the orthopedic acute ward who underwent surgical repair of a proximal femoral fracture. A multidisciplinary integrated model of care was established. Dedicated pathways were implemented in clinical practice to optimize the identification of high-risk persons, improve their evaluation through bone mineral density testing and blood examinations, and initiate an appropriate treatment for secondary prevention of falls and fragility fractures.Results: Compared with the pre-intervention phase, more hip-fractured persons received bone mineral density testing (47.62% versus 14.53%, P<0.0001), specific pharmacological treatments (48.51% versus 17.16%, P<0.0001), and an appointment for evaluation at a fall and fracture clinic (52.48% versus 2.37%, P<0.0001) in the post-intervention phase. Independent of some confounders, implementation of the FPS was positively associated with recommendations for secondary fracture prevention at discharge (P<0.0001) and with 1-year adherence to pharmacological treatment (P<0.0001).Conclusion: The FPS is an effective multidisciplinary integrated model of care to optimize identification of older persons at highest risk for fragility fracture, to improve their clinical management, and to increase adherence to prescriptions. Keywords: osteoporosis, secondary prevention, hip fracture, fracture liaison service, model of careRuggiero CZampi ERinonapoli GBaroni MSerra RZengarini EBaglioni GDuranti GErcolani SConti FCaraffa AMecocci PBrandi MLDove Medical Pressarticleosteoporosissecondary preventionhip fractureFracture liaison servicemodel of careGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1035-1042 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	osteoporosis secondary prevention hip fracture Fracture liaison service model of care Geriatrics RC952-954.6
spellingShingle	osteoporosis secondary prevention hip fracture Fracture liaison service model of care Geriatrics RC952-954.6 Ruggiero C Zampi E Rinonapoli G Baroni M Serra R Zengarini E Baglioni G Duranti G Ercolani S Conti F Caraffa A Mecocci P Brandi ML Fracture prevention service to bridge the osteoporosis care gap
description	Carmelinda Ruggiero,1 Elena Zampi,1 Giuseppe Rinonapoli,2 Marta Baroni,1 Rocco Serra,1 Elisa Zengarini,1 Gregorio Baglioni,3 Giuliana Duranti,3 Sara Ercolani,1 Francesco Conti,4 Auro Caraffa,2 Patrizia Mecocci,1 Maria Luisa Brandi5 1Geriatric Unit, University of Perugia, Hospital S Maria della Misericordia, 2Orthopedic and Traumatologic Unit, University of Perugia, Hospital S Maria della Misericordia, 3Primary Care Physicians, SIMG Umbria, Perugia, 4Department of Clinical and Molecular Medicine, Sapienza University of Rome, AO Sant’Andrea Hospital, Rome, 5Department of Internal Medicine, University of Florence, Florence, Italy Background: A care gap exists between the health care needs of older persons with fragility fractures and the therapeutic answers they receive. The Fracture Prevention Service (FPS), a tailored in-hospital model of care, may effectively bridge the osteoporosis care gap for hip-fractured older persons. The purpose of this study was to evaluate the efficacy of the FPS in targeting persons at high risk of future fracture and to improve their adherence to treatment.Methods: This was a prospective observational study conducted in a teaching hospital with traumatology and geriatric units, and had a pre-intervention and post-intervention phase. The records of 172 participants were evaluated in the pre-intervention phase, while data from 210 participants were gathered in the post-intervention phase. All participants underwent telephone follow-up at 12 months after hospital discharge. The participants were patients aged ≥65 years admitted to the orthopedic acute ward who underwent surgical repair of a proximal femoral fracture. A multidisciplinary integrated model of care was established. Dedicated pathways were implemented in clinical practice to optimize the identification of high-risk persons, improve their evaluation through bone mineral density testing and blood examinations, and initiate an appropriate treatment for secondary prevention of falls and fragility fractures.Results: Compared with the pre-intervention phase, more hip-fractured persons received bone mineral density testing (47.62% versus 14.53%, P<0.0001), specific pharmacological treatments (48.51% versus 17.16%, P<0.0001), and an appointment for evaluation at a fall and fracture clinic (52.48% versus 2.37%, P<0.0001) in the post-intervention phase. Independent of some confounders, implementation of the FPS was positively associated with recommendations for secondary fracture prevention at discharge (P<0.0001) and with 1-year adherence to pharmacological treatment (P<0.0001).Conclusion: The FPS is an effective multidisciplinary integrated model of care to optimize identification of older persons at highest risk for fragility fracture, to improve their clinical management, and to increase adherence to prescriptions. Keywords: osteoporosis, secondary prevention, hip fracture, fracture liaison service, model of care
format	article
author	Ruggiero C Zampi E Rinonapoli G Baroni M Serra R Zengarini E Baglioni G Duranti G Ercolani S Conti F Caraffa A Mecocci P Brandi ML
author_facet	Ruggiero C Zampi E Rinonapoli G Baroni M Serra R Zengarini E Baglioni G Duranti G Ercolani S Conti F Caraffa A Mecocci P Brandi ML
author_sort	Ruggiero C
title	Fracture prevention service to bridge the osteoporosis care gap
title_short	Fracture prevention service to bridge the osteoporosis care gap
title_full	Fracture prevention service to bridge the osteoporosis care gap
title_fullStr	Fracture prevention service to bridge the osteoporosis care gap
title_full_unstemmed	Fracture prevention service to bridge the osteoporosis care gap
title_sort	fracture prevention service to bridge the osteoporosis care gap
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/715ffc3fc99f4c91a8255c2fda8f0809
work_keys_str_mv	AT ruggieroc fracturepreventionservicetobridgetheosteoporosiscaregap AT zampie fracturepreventionservicetobridgetheosteoporosiscaregap AT rinonapolig fracturepreventionservicetobridgetheosteoporosiscaregap AT baronim fracturepreventionservicetobridgetheosteoporosiscaregap AT serrar fracturepreventionservicetobridgetheosteoporosiscaregap AT zengarinie fracturepreventionservicetobridgetheosteoporosiscaregap AT baglionig fracturepreventionservicetobridgetheosteoporosiscaregap AT durantig fracturepreventionservicetobridgetheosteoporosiscaregap AT ercolanis fracturepreventionservicetobridgetheosteoporosiscaregap AT contif fracturepreventionservicetobridgetheosteoporosiscaregap AT caraffaa fracturepreventionservicetobridgetheosteoporosiscaregap AT mecoccip fracturepreventionservicetobridgetheosteoporosiscaregap AT brandiml fracturepreventionservicetobridgetheosteoporosiscaregap
_version_	1718399343885549568

Fracture prevention service to bridge the osteoporosis care gap

Ejemplares similares