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Fracture Liaison Services (FLS) are increasingly recognised as a critical solution to the rising burden of osteoporosis-related fractures worldwide. Without effective intervention, the global incidence of hip fractures is projected to nearly double by 2050, according to a recent perspective article in the New England Journal of Medicine by Monash University expert, Professor Peter Ebeling AO.
Osteoporosis has been identified by the World Health Organization as a major global health issue, leading to significant disability and premature mortality. Hip fractures, in particular, are a leading cause of disability and long-term care among older adults. Statistics indicate that within the first year following a hip fracture, mortality rates can range from 14.4% to 28.3% for individuals living in the community and up to 55% for those in long-term care facilities.
Despite the availability of effective treatments, less than 20% of patients with fragility fractures receive appropriate pharmacologic interventions to strengthen bone and prevent future fractures. This highlights the urgent need for structured post-fracture care.
FLS are specialised programs designed to bridge the gap between acute fracture treatment and ongoing osteoporosis management. These services systematically identify, assess, and treat patients who have suffered fragility fractures to prevent subsequent fractures.
There are four primary FLS models, which typically include:
FLS programs have been shown to reduce secondary fractures by up to 74% within the first year and by 32% in subsequent years, offering both clinical and financial benefits.
Professor Ebeling highlights that FLS can provide a significant financial return, with an estimated return of $10.49 for every $1 invested. Health systems that have successfully implemented FLS, such as Kaiser Permanente in the United States, have reported substantial reductions in fracture rates, demonstrating the cost-effectiveness of these programs.
Despite their proven benefits, the adoption of FLS programs remains limited, particularly in countries like the United States, where a lack of reimbursement mechanisms hinders their widespread implementation. In contrast, countries such as the United Kingdom, Australia, and Japan have made significant strides in establishing FLS programs to support fracture prevention efforts.
Advocacy efforts led by organisations such as Healthy Bones Australia continue to push for greater investment in FLS programs nationwide. Expanding these services can help reduce the overall burden of osteoporosis-related fractures and improve patient outcomes across the country.
Fracture Liaison Services represent a crucial strategy in combating the rising incidence of osteoporosis-related fractures. With proven clinical and economic benefits, expanding FLS programs should be a priority for healthcare systems worldwide to ensure better outcomes for patients and reduce healthcare costs associated with osteoporosis management.
For those seeking GP jobs and resources, platforms like HealthcareLink, professional organisations and healthcare institutions offer various opportunities and support to contribute to the effective management of osteoporosis and related conditions.
Fracture Liaison Services can combat the rising osteoporosis-related fracture burden: expert
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