|Title:||Identifying characteristics of an effective fracture liaison service: systematic literature review||Authors:||Wu C.-H.
|Keywords:||Fracture liaison service; Intervention; Osteoporosis||Issue Date:||2018||Publisher:||Springer London||Journal Volume:||29||Journal Issue:||5||Start page/Pages:||1023-1047||Source:||Osteoporosis International||Abstract:||
Fracture liaison services (FLS) have been demonstrated to improve outcomes following osteoporotic fracture. The aim of this systematic literature review (SLR) was to determine the characteristics of an FLS that lead to improved patient outcomes. We conducted a SLR, including articles published between 2000 and February 2017, using global (Medline, EMBASE, PubMed and Cochrane Library) and local databases. Studies including patients aged ? 50?years with osteoporotic fractures enrolled in an FLS were assessed. Information extracted from each article included key person coordinating the FLS (physician, nurse or other healthcare professional), setting (hospital vs community), intensity (single vs multiple), duration (long vs short term), fracture type and gender. A meta-analysis of randomised controlled trials was conducted based on the key person coordinating the FLS. Out of 7236 articles, 57 were considered to be high quality and identified for further analysis. The SLR identified several components which contributed to FLS success, including multidisciplinary involvement, driven by a dedicated case manager, regular assessment and follow-up, multifaceted interventions and patient education. Meta-analytic data confirm the effectiveness of an FLS following an osteoporotic fracture: approximate 27% increase in the likelihood of BMD testing and up to 21% increase in the likelihood of treatment initiation compared with usual care. The balance of evidence indicates that the multifaceted FLS and dedicated coordination are important success factors that contribute to effective FLS interventions which reduce fracture-related morbidity and mortality. ? 2018, International Osteoporosis Foundation and National Osteoporosis Foundation.
|ISSN:||0937-941X||DOI:||10.1007/s00198-017-4370-z||SDG/Keyword:||bone density; clinical effectiveness; clinical practice; disease classification; evidence based practice; follow up; fracture liaison service; fragility fracture; health care personnel; health program; health service; human; intention to treat analysis; patient care; patient education; practice guideline; priority journal; quantitative analysis; Review; sex difference; systematic review; time to treatment; treatment outcome; fragility fracture; health care quality; integrated health care system; meta analysis; organization and management; osteoporosis; secondary prevention; bone density conservation agent; Bone Density Conservation Agents; Delivery of Health Care, Integrated; Humans; Osteoporosis; Osteoporotic Fractures; Quality Indicators, Health Care; Secondary Prevention
|Appears in Collections:||醫學系|
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