Implementing a fracture liaison service open model of care utilizing a cloud-based tool View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-02-10

AUTHORS

S. L. Greenspan, A. Singer, K. Vujevich, B. Marchand, D. A. Thompson, Y.-J. Hsu, D. Vaidya, L. S. Stern, D. Zeldow, D. B. Lee, S. Karp, R. Recker

ABSTRACT

PurposeAlthough half of women and one-quarter of men aged 50 and older will sustain an acute low-trauma fracture, less than a quarter receive appropriate secondary fracture prevention. The goal of this quality improvement demonstration project was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in three open health care systems aided by a cloud-based tool.MethodsThe pre–post study design examined the proportion of men and women over age 50 who received appropriate assessment (bone mineral density, vitamin D levels) and treatment (calcium/vitamin D, pharmacologic therapy) in the six months following a recently diagnosed fracture. The pre-study (Pre FLS) included a retrospective chart review for baseline data (N = 344 patients) within each health care system. In the post-evaluation (Post FLS, N = 148 patients), the FLS coordinator from each health care system examined these parameters following enrollment and for 6 months following the recently diagnosed fracture. Data were managed in the cloud-based FLS application tool.ResultsNinety-three participants completed the program. The FLS program increased the percentage of patients receiving bone mineral density testing from 21% at baseline to 93% (p < 0.001) Post FLS implementation. Assessments of vitamin D levels increased from 25 to 84% (p < 0.001). Patients prescribed calcium/vitamin D increased from 36% at baseline to 93% (p < 0.001) and those prescribed pharmacologic treatment for osteoporosis increased on average from 20 to 54% (p < 0.001) Post FLS.ConclusionsWe conclude that the FLS model of care in an open health care system, assisted by a cloud-based tool, significantly improved assessment and/or treatment of patients with a recently diagnosed osteoporotic fracture. Future studies are necessary to determine if this model of care is scalable and if such programs result in prevention of fractures. Mini-Abstract: The goal was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in open health care systems aided by a cloud-based tool. This model significantly improved assessment and/or treatment of patients with a recently diagnosed fracture. More... »

PAGES

953-960

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00198-017-4371-y

DOI

http://dx.doi.org/10.1007/s00198-017-4371-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1100959400

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29429033


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38 schema:description PurposeAlthough half of women and one-quarter of men aged 50 and older will sustain an acute low-trauma fracture, less than a quarter receive appropriate secondary fracture prevention. The goal of this quality improvement demonstration project was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in three open health care systems aided by a cloud-based tool.MethodsThe pre–post study design examined the proportion of men and women over age 50 who received appropriate assessment (bone mineral density, vitamin D levels) and treatment (calcium/vitamin D, pharmacologic therapy) in the six months following a recently diagnosed fracture. The pre-study (Pre FLS) included a retrospective chart review for baseline data (N = 344 patients) within each health care system. In the post-evaluation (Post FLS, N = 148 patients), the FLS coordinator from each health care system examined these parameters following enrollment and for 6 months following the recently diagnosed fracture. Data were managed in the cloud-based FLS application tool.ResultsNinety-three participants completed the program. The FLS program increased the percentage of patients receiving bone mineral density testing from 21% at baseline to 93% (p < 0.001) Post FLS implementation. Assessments of vitamin D levels increased from 25 to 84% (p < 0.001). Patients prescribed calcium/vitamin D increased from 36% at baseline to 93% (p < 0.001) and those prescribed pharmacologic treatment for osteoporosis increased on average from 20 to 54% (p < 0.001) Post FLS.ConclusionsWe conclude that the FLS model of care in an open health care system, assisted by a cloud-based tool, significantly improved assessment and/or treatment of patients with a recently diagnosed osteoporotic fracture. Future studies are necessary to determine if this model of care is scalable and if such programs result in prevention of fractures. Mini-Abstract: The goal was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in open health care systems aided by a cloud-based tool. This model significantly improved assessment and/or treatment of patients with a recently diagnosed fracture.
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46 D levels
47 FL implementation
48 FLS coordinator
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51 age 50
52 application tool
53 appropriate assessment
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55 baseline
56 baseline data
57 bone mineral density testing
58 calcium/vitamin D
59 care
60 care system
61 chart review
62 cloud-based tools
63 coordinator
64 data
65 demonstration project
66 density testing
67 design
68 enrollment
69 fracture liaison service
70 fracture prevention
71 fractures
72 future studies
73 goal
74 half
75 health care system
76 implementation
77 levels
78 liaison service
79 low-trauma fractures
80 men
81 model
82 model of care
83 months
84 one-quarter
85 open model
86 osteoporosis
87 osteoporotic fractures
88 parameters
89 participants
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91 percentage
92 percentage of patients
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95 prevention
96 prevention of fractures
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104 secondary fracture prevention
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