Authors (including presenting author) :
Tam SM(1), Tiu KL(1), Lee KB(1), Tsang KK(1), Wong KI(1), Li Wilson(1)
Affiliation :
(1) Department of Orthopaedics & Traumatology , Queen Elizabeth Hospital
Introduction :
Fracture Liaison Service (FLS) has built up in Department of Orthopaedics & Traumatology (O&T) with contribution of multidisciplinary Fragility Fracture(FF) team since 2017. It becomes a key and comprehensive program to prevent secondary fracture among FF patients. Fracture Liaison Nurse (FLN) keeps ensure Fragility Hip Fracture (FHF) patients to have a smooth patient journey during hospitalization, coordinates multidisciplinary team (MDT) service and applies “3 I” protocol for osteoporosis screening and care. FLS not only focus on prescription of anti-osteoporotic treatment but also reinforcing drug compliance and promoting rehabilitation. MDT members provide education including bone health, nutrition, exercise and home safety. In addition, each discipline performs independent assessment to identify patients’ potential problem(s) and gives relevant advice. A 3-year data is collected and our team performs a summative assessment to review interim effect of FLS. In order to monitor its long-term effect and figure out a plan of extending FLS, a structured patient-based electronic clinical pathway is built and a pilot program is started recently.
Objectives :
To evaluate FLS in O&T Department
Methodology :
We evaluated FLS after the third year of introduction by reviewing all new FHF admission to O&T department and patients attending G9FF clinic between 2017-2019 retrospectively.
Result & Outcome :
FLS in O&T department provides quality FHF care and secondary fracture prevention for FF patients. FLN has provided bone health assessment and education to 1,895 FF patients and 774 of them have initiated and continued anti-osteoporosis management since 2017 under the whole team’s effort. A satisfactory and persistent treatment initiation rate (84%) was observed in 2018 & 2019. A higher drug compliance rate (93%) was recorded in 2019 and all of them attending G9FF day clinic received MDT service. The rate of secondary fall was slightly lower 1.3% and reached 17% in 2019 as compared to 2017. But the rate of secondary fracture kept decreasing from 4.67% in 2017 to 2.82% in 2019 with 40 % reduction in percentage. Hence, FLS begins to reveal its effect on preventing secondary fracture and the interim service review demonstrates FLS is a feasible service model with encouraging results.
