Authors (including presenting author) :
Yu PHV(1), Wan KHM(1), Lin HK(1), Lo WMS(1), Man KH(1), Fung LS(1), Yu LF(1), Yeung CYJ(2), Chan TY(2), Wong KK(1)
Affiliation :
(1) Department of Orthopaedics and Traumatology, Kwong Wah Hospital (2) Department of Medicine and Geriatrics, Kwong Wah Hospital
Introduction :
Similar to other developed countries and regions, we are faced with the problem of an ageing population and the burden of osteoporotic fracture to our medical system is increasing. As a regional district-general hospital, the most common osteoporotic fractures admitted to our in-patient services are vertebral fracture and geriatric hip fracture. Fracture Liaison Services, commonly known as FLS, are coordinator-based, multidisciplinary secondary prevention services for the treatment of osteoporotic patients.
Objectives :
Our fracture liaison Programme aims to systemically identify, investigate, initiate and adhere treatment for all patients with fragility fractures, with the aim of reducing their risks of subsequent fractures. It also aims to influence our clinical practice through continuous auditing and feedback.
Methodology :
Patients with osteoporotic fractures of two vertebrae or geriatric hip fracture in addition to one fragility fracture are included into our programme. They are then assessed by geriatricians to see whether they are indicated for osteoporosis parental therapy of zoledronic acid (Aclasta) or denosumab (Prolia). Patient’s information is then entered into the virtual ortho-geriatric ward system at the HA intranet, including the type of medication received and the injection dates. Blood tests are taken before the injection in order to reduce the risk of transient hypercalcemia caused by the medications. The injection takes place at our Ambulatory Orthopaedic Service (AOS) Centre. Designated follow-up sessions are arranged at the out-patient clinics. Nursing colleagues play an important part in this programme, who provide patient education in areas of lifestyle modifications, dietary advice and telephone consultations on drug compliance and identification of possible side effects caused by the medications.
Result & Outcome :
Despite the challenges posed by the COVID-19 pandemic in the past year, with the implantation of numerus social distancing measures, we were still able to kick start our programme. From October 2019 to December 2020, 29 patients have been recruited into our programme. Four patients were excluded subsequently (one patient had impaired renal function, two patients had refused injection, and one patient had defaulted our programme), Of the 25 patients, 17 patients suffered from vertebral fracture, while 8 patients suffered from geriatric hip fracture. With the implementation of our fracture liaison programme, we hope that the risks of patients suffering yet another fracture can be reduced.
