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Fracture Liaison Services

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Osteoporosis in Older Persons

Abstract

People who suffer a fragility fracture are at substantially increased risk of suffering second and subsequent fractures. However, a pervasive and persistent secondary fracture prevention care gap is well documented throughout the world. In response to this challenge, Fracture Liaison Services (FLS) have been established in a growing number of countries. This chapter provides an overview of how FLS function and describes initiatives intended to promulgate these clinically effective and cost-effective models of care. Guidance on the practicalities of implementing an FLS is also provided.

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References

  1. Gallagher JC, Melton LJ, Riggs BL, Bergstrath E. Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop Relat Res. 1980;(150):163–71. PubMed Epub 1980/07/01. eng.

    Google Scholar 

  2. Port L, Center J, Briffa NK, Nguyen T, Cumming R, Eisman J. Osteoporotic fracture: missed opportunity for intervention. Osteoporos Int. 2003;14(9):780–4. PubMed Epub 2003/08/09. eng.

    Article  PubMed  Google Scholar 

  3. McLellan A, Reid D, Forbes K, Reid R, Campbell C, Gregori A, et al. Effectiveness of strategies for the secondary prevention of osteoporotic fractures in Scotland (CEPS 99/03). Glasgow, Scotland: NHS Quality Improvement Scotland; 2004.

    Google Scholar 

  4. Edwards BJ, Bunta AD, Simonelli C, Bolander M, Fitzpatrick LA. Prior fractures are common in patients with subsequent hip fractures. Clin Orthop Relat Res. 2007;461:226–30. PubMed Epub 2007/04/07. eng.

    PubMed  Google Scholar 

  5. Klotzbuecher CM, Ross PD, Landsman PB, Abbott 3rd TA, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15(4):721–39. PubMed Epub 2000/04/26. eng.

    Article  CAS  PubMed  Google Scholar 

  6. Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004;35(2):375–82. PubMed Epub 2004/07/23. eng.

    Article  CAS  PubMed  Google Scholar 

  7. Capture the fracture: a global campaign to break the fragility fracture cycle. Nyon: International Osteoporosis Foundation; 2012.

    Google Scholar 

  8. Make the FIRST break the LAST with Fracture Liaison Services. Osteoporosis Canada; 2013.

    Google Scholar 

  9. Bone care 2020: a systematic approach to hip fracture care and prevention for New Zealand. Wellington: Osteoporosis New Zealand; 2012.

    Google Scholar 

  10. National Bone Health Alliance. Fracture prevention CENTRAL 2014, 18 Aug 2014. Available from: http://www.nbha.org/fpc.

  11. Cooper C, Mitchell P, Kanis JA. Breaking the fragility fracture cycle. Osteoporos Int. 2011;22(7):2049–50. PubMed Epub 2011/05/25. eng.

    Article  CAS  PubMed  Google Scholar 

  12. Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, et al. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet. 1996;348(9041):1535–41. PubMed Epub 1996/12/07. eng.

    Article  CAS  PubMed  Google Scholar 

  13. Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999;282(7):637–45. PubMed Epub 1999/10/12. eng.

    Article  CAS  PubMed  Google Scholar 

  14. Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, et al. Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA. 1999;282(14):1344–52. PubMed Epub 1999/10/20. eng.

    Article  CAS  PubMed  Google Scholar 

  15. Reginster J, Minne HW, Sorensen OH, Hooper M, Roux C, Brandi ML, et al. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral Efficacy with Risedronate Therapy (VERT) Study Group. Osteoporos Int. 2000;11(1):83–91. PubMed Epub 2000/02/09. eng.

    Article  CAS  PubMed  Google Scholar 

  16. Torgerson DJ, Bell-Syer SE. Hormone replacement therapy and prevention of nonvertebral fractures: a meta-analysis of randomized trials. JAMA. 2001;285(22):2891–7. PubMed Epub 2001/06/13. eng.

    Article  CAS  PubMed  Google Scholar 

  17. McClung MR, Geusens P, Miller PD, Zippel H, Bensen WG, Roux C, et al. Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med. 2001;344(5):333–40. PubMed Epub 2001/02/15. eng.

    Article  CAS  PubMed  Google Scholar 

  18. Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344(19):1434–41. PubMed Epub 2001/05/11. eng.

    Article  CAS  PubMed  Google Scholar 

  19. Chesnut IC, Skag A, Christiansen C, Recker R, Stakkestad JA, Hoiseth A, et al. Effects of oral ibandronate administered daily or intermittently on fracture risk in postmenopausal osteoporosis. J Bone Miner Res. 2004;19(8):1241–9. PubMed Epub 2004/07/03. eng.

    Article  CAS  PubMed  Google Scholar 

  20. Meunier PJ, Roux C, Seeman E, Ortolani S, Badurski JE, Spector TD, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004;350(5):459–68. PubMed Epub 2004/01/30. eng.

    Article  CAS  PubMed  Google Scholar 

  21. Reginster JY, Seeman E, De Vernejoul MC, Adami S, Compston J, Phenekos C, et al. Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) study. J Clin Endocrinol Metabol. 2005;90(5):2816–22. PubMed Epub 2005/02/25. eng.

    Article  CAS  Google Scholar 

  22. Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007;356(18):1809–22. PubMed Epub 2007/05/04. eng.

    Article  CAS  PubMed  Google Scholar 

  23. Lyles KW, Colon-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, Mautalen C, et al. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007;357(18):1799–809. PubMed Epub 2007/09/20. eng.

    Article  CAS  PubMed  Google Scholar 

  24. Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361(8):756–65. PubMed Epub 2009/08/13. eng.

    Article  CAS  PubMed  Google Scholar 

  25. Elliot-Gibson V, Bogoch ER, Jamal SA, Beaton DE. Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int. 2004;15(10):767–78. PubMed Epub 2004/07/20. eng.

    Article  CAS  PubMed  Google Scholar 

  26. Giangregorio L, Papaioannou A, Cranney A, Zytaruk N, Adachi JD. Fragility fractures and the osteoporosis care gap: an international phenomenon. Semin Arthritis Rheum. 2006;35(5):293–305. PubMed Epub 2006/04/18. eng.

    Article  CAS  PubMed  Google Scholar 

  27. National Osteoporosis Society. Protecting fragile bones: a strategy to reduce the impact of osteoporosis and fragility fractures in England/Scotland/Wales/Northern Ireland. 2009 May–Jun 2009. Report No.

    Google Scholar 

  28. International Osteoporosis Foundation. Capture the fracture: break the worldwide fragility fracture cycle 2014. 18 Aug 2014. Available from: http://www.capturethefracture.org/.

  29. The state of health care quality report 2014. Washington, DC: National Committee for Quality Assurance; 2014.

    Google Scholar 

  30. Health and Social Care Information Centre. Quality and outcomes framework – prevalence, achievements and exceptions report: England, 2013-14. Leeds; 2014.

    Google Scholar 

  31. Chami G, Jeys L, Freudmann M, Connor L, Siddiqi M. Are osteoporotic fractures being adequately investigated? A questionnaire of GP & orthopaedic surgeons. BMC Family Pract. 2006;7:7. PubMed Pubmed Central PMCID: 1388220, Epub 2006/02/09. eng.

    Article  Google Scholar 

  32. McLellan AR, Gallacher SJ, Fraser M, McQuillian C. The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int. 2003;14(12):1028–34. PubMed Epub 2003/11/06. eng.

    Article  PubMed  Google Scholar 

  33. Bogoch ER, Elliot-Gibson V, Beaton DE, Jamal SA, Josse RG, Murray TM. Effective initiation of osteoporosis diagnosis and treatment for patients with a fragility fracture in an orthopaedic environment. J Bone Joint Surg Am. 2006;88(1):25–34. PubMed Epub 2006/01/05. eng.

    Article  PubMed  Google Scholar 

  34. Dell R, Greene D, Schelkun SR, Williams K. Osteoporosis disease management: the role of the orthopaedic surgeon. J Bone Joint Surg Am. 2008;90 Suppl 4:188–94. PubMed Epub 2008/11/15. eng.

    Article  PubMed  Google Scholar 

  35. Lih A, Nandapalan H, Kim M, Yap C, Lee P, Ganda K, et al. Targeted intervention reduces refracture rates in patients with incident non-vertebral osteoporotic fractures: a 4-year prospective controlled study. Osteoporos Int. 2011;22(3):849–58. PubMed Epub 2010/11/26. eng.

    Article  CAS  PubMed  Google Scholar 

  36. Cooper MS, Palmer AJ, Seibel MJ. Cost-effectiveness of the Concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study. Osteoporos Int. 2012;23(1):97–107. PubMed Epub 2011/09/29. eng.

    Article  CAS  PubMed  Google Scholar 

  37. Sander B, Elliot-Gibson V, Beaton DE, Bogoch ER, Maetzel A. A coordinator program in post-fracture osteoporosis management improves outcomes and saves costs. J Bone Joint Surg Am. 2008;90(6):1197–205. PubMed Epub 2008/06/04. eng.

    Article  PubMed  Google Scholar 

  38. McLellan AR, editor. Putting FLS into context: patients, professionals and policymakers. National osteoporosis society FLS education programme 2010 October 2010; Bristol/London/Newcastle/Cardiff/Manchester/Birmingham: National Osteoporosis Society.

    Google Scholar 

  39. McLellan AR, Wolowacz SE, Zimovetz EA, Beard SM, Lock S, McCrink L, et al. Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. Osteoporos Int. 2011;22(7):2083–98. PubMed Epub 2011/05/25. eng.

    Article  CAS  PubMed  Google Scholar 

  40. Dell R. Fracture prevention in Kaiser Permanente Southern California. Osteoporos Int. 2011;22 Suppl 3:457–60. PubMed Epub 2011/08/24. eng.

    Article  PubMed  Google Scholar 

  41. Boudou L, Gerbay B, Chopin F, Ollagnier E, Collet P, Thomas T. Management of osteoporosis in fracture liaison service associated with long-term adherence to treatment. Osteoporos Int. 2011;22(7):2099–106. PubMed Epub 2011/04/30. eng.

    Article  CAS  PubMed  Google Scholar 

  42. Ahmed M, Durcan L, O’Beirne J, Quinlan J, Pillay I. Fracture liaison service in a non-regional orthopaedic clinic – a cost-effective service. Ir Med J. 2012;105(1):24, 6–7. PubMed.

    CAS  PubMed  Google Scholar 

  43. Wallace I, Callachand F, Elliott J, Gardiner P. An evaluation of an enhanced fracture liaison service as the optimal model for secondary prevention of osteoporosis. JRSM Short Rep. 2011;2(2):8. PubMed Pubmed Central PMCID: 3046558, Epub 2011/03/04. eng.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Chandran M, Tan MZ, Cheen M, Tan SB, Leong M, Lau TC. Secondary prevention of osteoporotic fractures – an “OPTIMAL” model of care from Singapore. Osteoporos Int. 2013;24(11):2809–17. PubMed.

    Article  CAS  PubMed  Google Scholar 

  45. Carpintero P, Gil-Garay E, Hernandez-Vaquero D, Ferrer H, Munuera L. Interventions to improve inpatient osteoporosis management following first osteoporotic fracture: the PREVENT project. Arch Orthop Trauma Surg. 2009;129(2):245–50. PubMed Epub 2009/01/07. eng.

    Article  PubMed  Google Scholar 

  46. Chevalley T, Hoffmeyer P, Bonjour JP, Rizzoli R. An osteoporosis clinical pathway for the medical management of patients with low-trauma fracture. Osteoporos Int. 2002;13(6):450–5. PubMed Epub 2002/07/11. eng.

    Article  CAS  PubMed  Google Scholar 

  47. Huntjens KM, van Geel TC, Geusens PP, Winkens B, Willems P, van den Bergh J, et al. Impact of guideline implementation by a fracture nurse on subsequent fractures and mortality in patients presenting with non-vertebral fractures. Injury. 2011;42 Suppl 4:S39–43. PubMed Epub 2011/10/05. eng.

    Article  PubMed  Google Scholar 

  48. International Osteoporosis Foundation. Map of best practice 2014. 23 Dec 2014. Available from: http://capturethefracture.org/map-of-best-practice.

  49. Bolland MJ, Grey AB, Gamble GD, Reid IR. Effect of osteoporosis treatment on mortality: a meta-analysis. J Clin Endocrinol Metabol. 2010;95(3):1174–81. PubMed Epub 2010/01/19. eng.

    Article  CAS  Google Scholar 

  50. Center JR, Bliuc D, Nguyen ND, Nguyen TV, Eisman JA. Osteoporosis medication and reduced mortality risk in elderly women and men. J Clin Endocrinol Metabol. 2011;96(4):1006–14. PubMed Epub 2011/02/04. eng.

    Article  CAS  Google Scholar 

  51. Beaupre LA, Morrish DW, Hanley DA, Maksymowych WP, Bell NR, Juby AG, et al. Oral bisphosphonates are associated with reduced mortality after hip fracture. Osteoporos Int. 2011;22(3):983–91. PubMed Epub 2010/11/06. eng.

    Article  CAS  PubMed  Google Scholar 

  52. Sambrook PN, Cameron ID, Chen JS, March LM, Simpson JM, Cumming RG, et al. Oral bisphosphonates are associated with reduced mortality in frail older people: a prospective five-year study. Osteoporos Int. 2011;22(9):2551–6. PubMed Epub 2010/10/21. eng.

    Article  CAS  PubMed  Google Scholar 

  53. Huntjens KM, van Geel TA, van den Bergh JP, van Helden S, Willems P, Winkens B, et al. Fracture liaison service: impact on subsequent nonvertebral fracture incidence and mortality. J Bone Joint Surg Am. 2014;96(4):e29. PubMed.

    Article  PubMed  Google Scholar 

  54. Little EA, Eccles MP. A systematic review of the effectiveness of interventions to improve post-fracture investigation and management of patients at risk of osteoporosis. Implement Sci. 2010;5:80. PubMed Pubmed Central PMCID: 2988064, Epub 2010/10/26.eng.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Sale JE, Beaton D, Posen J, Elliot-Gibson V, Bogoch E. Systematic review on interventions to improve osteoporosis investigation and treatment in fragility fracture patients. Osteoporos Int. 2011;22(7):2067–82. PubMed.

    Article  CAS  PubMed  Google Scholar 

  56. Ganda K, Puech M, Chen JS, Speerin R, Bleasel J, Center JR, et al. Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int. 2013;24(2):393–406. PubMed Epub 2012/07/26. Eng.

    Article  CAS  PubMed  Google Scholar 

  57. National Institute for Health and Clinical Excellence. Bisphosphonates (alendronate, etidronate, risedronate), selective oestrogen receptor modulators (raloxifene) and parathyroid hormone (teriparatide) for the secondary prevention of osteoporotic fragility fractures in postmenopausal women, Technology appraisal guidance, vol. 87. London: National Institute for Clinical Excellence (NICE); 2005.

    Google Scholar 

  58. Akesson K, Marsh D, Mitchell PJ, McLellan AR, Stenmark J, Pierroz DD, et al. Capture the fracture: a best practice framework and global campaign to break the fragility fracture cycle. Osteoporos Int. 2013;24(8):2135–52. Epub 2013/04/16.

    Google Scholar 

  59. Osteoporosis Canada. Quality standards for fracture liaison services in Canada. Toronto: Osteoporosis Canada; 2014.

    Google Scholar 

  60. Gittoes N, McLellan AR, Cooper A, Dockery F, Davenport G, Goodwin V, et al. Effective secondary prevention of fragility fractures: clinical standards for fracture liaison services (draft for consultation). Camerton: National Osteoporosis Society; 2014.

    Google Scholar 

  61. Papaioannou A, Morin S, Cheung AM, Atkinson S, Brown JP, Feldman S, et al. 2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary. CMAJ. 2010;182(17):1864–73. PubMed Pubmed Central PMCID: 2988535.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Gittoes N, McLellan AR, Cooper A, Dockery F, Davenport G, Goodwin V, et al. Effective secondary prevention of fragility fractures: clinical standards for fracture liaison services. Camerton: National Osteoporosis Society; 2014.

    Google Scholar 

  63. Health Quality and Safety Commission. Topic 6: why hip fracture prevention and care matters. Wellington; 2013, 18 Aug 2014. Available from: http://www.hqsc.govt.nz/our-programmes/reducing-harm-from-falls/10-topics/topic-6/.

  64. Mitchell PJ, Cornish J, Milsom S, Hayman L, Seibel MJ, Close J, et al. BoneCare 2020: a systematic approach to hip fracture care and prevention for New Zealand. 3rd fragility fracture network congress 2014, 4–6 Sept 2014, Madrid; 2014.

    Google Scholar 

  65. Osteoporosis New Zealand. Fracture liaison services resource pack. Wellington: Osteoporosis New Zealand; 2014.

    Google Scholar 

  66. Eisman JA, Bogoch ER, Dell R, Harrington JT, McKinney Jr RE, McLellan A, et al. Making the first fracture the last fracture: ASBMR task force report on secondary fracture prevention. J Bone Miner Res. 2012;27(10):2039–46. PubMed Epub 2012/07/28. eng.

    Article  PubMed  Google Scholar 

  67. Eisman JA, Bogoch ER, Dell R, Harrington JT, McKinney RE Jr, McLellan A, et al. Appendix A to 'making the first fracture the last fracture': ASBMR task force report on secondary fracture prevention 2012. 1 Nov 2012. Available from: http://onlinelibrary.wiley.com/doi/10.1002/jbmr.1698/suppinfo.

  68. Mitchell PJ, Ganda K, Seibel MJ. Australian and New Zealand Bone and Mineral Society Position Paper on Secondary Fracture Prevention Programs: A Call to Action. Australian and New Zealand Bone and Mineral Society; (In press: 2015).

    Google Scholar 

  69. Osteoporosis: towards a fracture free future. Toronto: Osteoporosis Canada; 2011.

    Google Scholar 

  70. Osteoporosis Canada. Osteoporosis patient bill of rights 2011. Available from: http://www.osteoporosis.ca/osteoporosis-and-you/copn/patient-bill-of-rights/.

  71. Australian and New Zealand Hip Fracture Registry (ANZHFR) Steering Group. Australian and New Zealand guideline for hip fracture care: improving outcomes in hip fracture management of adults. Sydney: Australian and New Zealand Hip Fracture Registry Steering Group; 2014.

    Google Scholar 

  72. Clinical Effectiveness and Evaluation Unit. Falling standards, broken promises: report of the national audit of falls and bone health in older people 2010. Royal College of Physicians; 2011.

    Google Scholar 

  73. All wales audit of secondary prevention of osteoporotic fractures 2012. Aberystwyth: All Wales Osteoporosis Advisory Group; 2012.

    Google Scholar 

  74. The National Falls Programme in association with WorksOut as part of the Delivery Framework for Adult Rehabilitation in Scotland. Up and about or falling short? A report of the findings of a mapping of services for falls prevention and management and fracture prevention in older people in Scotland. Edinburgh: The Scottish Government; 2012.

    Google Scholar 

  75. Mitchell PJ. Fracture liaison services in the United Kingdom. Curr Osteoporos Rep. 2013;11(4):377–84. PubMed.

    Article  PubMed  Google Scholar 

  76. National hip fracture database (NHFD) extended report 2014. London: Royal College of Physicians; 2014.

    Google Scholar 

  77. British Geriatrics Society. The care of patients with fragility fracture. British Orthopaedic Association; 2007.

    Google Scholar 

  78. British Geriatrics Society. Best practice tariff for hip fracture – making ends meet 2010. 15 Mar 2012. Available from: http://www.bgs.org.uk/index.php?option=com_content&view=article&id=700:tariffhipfracture&catid=47:fallsandbones&Itemid=307.

  79. National Bone Health Alliance. National bone health alliance: strong bones America Washington D.C. 2013. 17 Jan 2013. Available from: http://www.nbha.org/.

  80. National Bone Health Alliance. 2Million2Many 2014, 18 Aug 2014. Available from: http://www.2million2many.org/.

  81. Harrington JT, Barash HL, Day S, Lease J. Redesigning the care of fragility fracture patients to improve osteoporosis management: a health care improvement project. Arthritis Rheum. 2005;53(2):198–204. PubMed Epub 2005/04/09. eng.

    Article  PubMed  Google Scholar 

  82. Stephenson S. Developing an orthopaedic elderly care liaison service. J Orthop Nursing. 2003;7(3):150–5.

    Article  Google Scholar 

  83. Giles M, Van Der Kallen J, Parker V, Cooper K, Gill K, Ross L, et al. A team approach: implementing a model of care for preventing osteoporosis related fractures. Osteoporos Int. 2011;22(8):2321–8. PubMed Epub 2010/11/04. eng.

    Article  CAS  PubMed  Google Scholar 

  84. Kaiser Permanente. Connectivity: comprehensive health information at your fingertips 2015. Cited 18 Feb 2015. Available from: http://share.kaiserpermanente.org/total-health/connectivity/.

  85. Riomed Limited. FITOS = Fracture identification tool for orthopaedic surgeons Eastleigh, UK; 2015. Cited 18 Feb 2015. Available from: http://www.riomed.com/fitos.html.

  86. Vaile J, Sullivan L, Bennett C, Bleasel J. First fracture project: addressing the osteoporosis care gap. Intern Med J. 2007;37(10):717–20. PubMed Epub 2007/09/27. eng.

    Article  CAS  PubMed  Google Scholar 

  87. Kuo I, Ong C, Simmons L, Bliuc D, Eisman J, Center J. Successful direct intervention for osteoporosis in patients with minimal trauma fractures. Osteoporos Int. 2007;18(12):1633–9. PubMed Epub 2007/07/03. eng.

    Article  CAS  PubMed  Google Scholar 

  88. Delmas PD, van de Langerijt L, Watts NB, Eastell R, Genant H, Grauer A, et al. Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study. J Bone Miner Res. 2005;20(4):557–63. PubMed Epub 2005/03/15. eng.

    Article  PubMed  Google Scholar 

  89. Lems WF. Clinical relevance of vertebral fractures. Ann Rheum Dis. 2007;66(1):2–4. PubMed Pubmed Central PMCID: 1798393, Epub 2006/12/21. eng.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  90. Blonk MC, Erdtsieck RJ, Wernekinck MG, Schoon EJ. The fracture and osteoporosis clinic: 1-year results and 3-month compliance. Bone. 2007;40(6):1643–9. PubMed Epub 2007/04/17. eng.

    Article  PubMed  Google Scholar 

  91. Premaor MO, Pilbrow L, Tonkin C, Adams M, Parker RA, Compston J. Low rates of treatment in postmenopausal women with a history of low trauma fractures: results of audit in a Fracture Liaison Service. QJM. 2010;103(1):33–40. PubMed Epub 2009/10/30. eng.

    Article  CAS  PubMed  Google Scholar 

  92. Clunie G, Stephenson S. Implementing and running a fracture liaison service: an integrated clinical service providing a comprehensive bone health assessment at the point of fracture management. J Orthop Nursing. 2008;12:156–62. Epub 21-11-2008.

    Article  Google Scholar 

  93. Jager PL, Slart RH, Webber CL, Adachi JD, Papaioannou AL, Gulenchyn KY. Combined vertebral fracture assessment and bone mineral density measurement: a patient-friendly new tool with an important impact on the Canadian Risk Fracture Classification. Can Assoc Radiol J. 2010;61(4):194–200. PubMed Epub 2010/03/05. eng.

    Article  PubMed  Google Scholar 

  94. Chang HT, Chen CK, Chen CW, Lin MH, Peng LN, Chang CY, et al. Unrecognized vertebral body fractures (VBFs) in chest radiographic reports in Taiwan: a hospital-based study. Arch Gerontol Geriatr. 2012;55(2):301–4. PubMed Epub 2011/10/08. eng.

    Article  PubMed  Google Scholar 

  95. Chan PL, Reddy T, Milne D, Bolland MJ. Incidental vertebral fractures on computed tomography. N Z Med J. 2012;125(1350):45–50. PubMed Epub 2012/03/03. eng.

    PubMed  Google Scholar 

  96. Bazzocchi A, Spinnato P, Garzillo G, Ciccarese F, Albisinni U, Mignani S, et al. Detection of incidental vertebral fractures in breast imaging: the potential role of MR localisers. Eur Radiol. 2012;22(12):2617–23. PubMed.

    Article  PubMed  Google Scholar 

  97. Osteoporosis Australia. Detection, prevention and treatment of osteoporosis. Melbourne: Royal Australian College of General Practitioners; 2010.

    Google Scholar 

  98. Denosumab for the prevention of osteoporotic fractures in postmenopausal women: NICE technology appraisal guidance 204. London: National Institute for Health and Clinical Excellence; 2010.

    Google Scholar 

  99. Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. NICE technology appraisal guidance 161 (amended). London: National Institute for Health and Clinical Excellence; 2011.

    Google Scholar 

  100. Clinician’s guide to prevention and treatment of osteoporosis. Washington, DC: National Osteoporosis Foundation; 2013.

    Google Scholar 

  101. Seeman E, Compston J, Adachi J, Brandi ML, Cooper C, Dawson-Hughes B, et al. Non-compliance: the Achilles’ heel of anti-fracture efficacy. Osteoporos Int. 2007;18(6):711–9. PubMed Epub 2007/01/25. eng.

    Article  CAS  PubMed  Google Scholar 

  102. Kanis JA, Johnell O. The burden of osteoporosis. J Endocrinol Invest. 1999;22(8):583–8.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Paul J. Mitchell BSc (Hons), C.Chem., MRSC .

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Mitchell, P.J. (2016). Fracture Liaison Services. In: Duque, G., Kiel, D. (eds) Osteoporosis in Older Persons. Springer, Cham. https://doi.org/10.1007/978-3-319-25976-5_13

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