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Osteologie 2014; 23(01): 39-44
DOI: 10.1055/s-0037-1620030
Trauma in the elderly
Schattauer GmbH

Systematic approaches to fragility fracture prevention

International experienceSystematische Verfahren zur Vermeidung von FragilitätsfrakturenInternationale Erfahrungswerte
P. J. Mitchell
1   Synthesis Medical NZ Limited, Pukekohe/New Zealand
,
D. B. Lee
2   National Bone Health Alliance, Washington/USA
› Author Affiliations
Further Information

Publication History

received: 15 November 2013

accepted: 19 December 2013

Publication Date:
02 January 2018 (online)

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Summary

Individuals who have suffered fractures caused by osteoporosis – also known as fragility fractures – are the most readily identifiable group at high risk of suffering future fractures. Globally, the majority of these individuals do not receive the secondary preventive care that they need. The Fracture Liaison Service model (FLS) has been developed to ensure that fragility fracture patients are reliably identified, investigated for future fracture and falls risk, and initiated on treatment in accordance with national clinical guidelines. FLS have been successfully established in Asia, Europe, Latin America, North America and Oceania, and their widespread implementation is endorsed by leading national and international osteoporosis organisations. Multi-sector coalitions have expedited inclusion of FLS into national policy and reimbursement mechanisms. The largest national coalition, the National Bone Health Alliance (NBHA) in the United States, provides an exemplar of achieving participation and consensus across sectors. Initiatives developed by NBHA could serve to inform activities of new and emerging coalitions in other countries.

Zusammenfassung

Personen mit bekannter Osteoporose und Knochenbrüchen sind die am leichtesten identifizierbare Gruppe mit einem hohen Risiko für zukünftige Frakturen. Weltweit ist die Mehrheit dieser Personen untertherapiert und erhält nicht die benötigte sekundäre Prävention. Das Fracture Liaison-Service-Modell (FLS) wurde entwickelt, um sicherzustellen, dass Patienten mit Fragilitätsfrakturen zuverlässig erkannt und für das zukünftige Frakturund Sturzrisiko untersucht werden, und dass die Behandlung in Übereinstimmung mit den nationalen klinischen Richtlinien initiiert wird. FLS wurden erfolgreich in Asien, Europa, Lateinamerika, Nordamerika und Ozeanien gegründet, und deren flächendeckende Umsetzung wird von führenden nationalen und internationalen Osteoporoseorganisationen unterstützt. Koalitionen aus verschiedenen Interessensgruppen haben die Aufnahme des FLS in die nationale Gesundheitspolitik und damit auch die finanzielle Abdeckung beschleunigt. Die größte nationale Vereinigung ist die National Bone Health Alliance (NBHA) in den Vereinigten Staaten. Diese ist ein Musterbeispiel dafür, dass eine Beteiligung und auch ein Konsens zwischen verschiedenen Interessensgruppen erreicht werden kann. Die Aktivitäten der NBHA können auch dazu dienen, neue Initiativen in diversen Ländern zu fördern.

Keywords

Osteoporosis - fragility - fracture - fracture prevention

Schlüsselwörter

Osteoporose - Fragilität - Fraktur - Frakturvermeidung
 

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