A large number of fractures could be prevented by targeted osteoporosis therapy and effective preventive measures against falls. In patients with osteoporosis-associated fractures, the underlying osteoporosis is rarely clarified and treated under the conditions of standard care. Although every osteoporosis-associated fracture is preceded by a fall, there is usually no structured fall prevention. These omissions often lead to further fractures with resulting hospital stays due to additional surgeries.
The Fracture-Liaison-Service (FLS) Case-Management aims to reduce the frequency of subsequent fractures by counteracting their causes in a targeted and sustainable manner. This is an interprofessional care model with an integrated and guideline-based care concept in a network consisting of doctors and nurses from the outpatient and inpatient sectors. This is to ensure that fracture prevention initiated in the inpatient sector is continued in outpatient care.
During the inpatient stay, patients with osteoporosis-associated hip fracture are identified and educated about the content and timing of the care program to prevent a subsequent fracture. Patients included in the model are first diagnosed and then treated for underlying osteoporosis based on guideline-based diagnostic and treatment pathways. In addition, the patients are taking part in a fall prevention program.
Although the cost-effectiveness of the FLS has already been demonstrated in the Anglo-American field, there is hardly any FLS in Germany based on this model. The project "Fracture Liaison Service - Implementation of an Integrated Care Structure for the Prevention of Osteoporosis-Related Subsequent Fractures (FLS-CARE)", which is funded by the Innovation Fund of the Federal Joint Committee (G-BR), is attempting to close this gap under the leadership of the Department of General, Trauma and Reconstructive Surgery of the LMU. The Chair of Health Economics will conduct the evaluation of the cluster-randomized trial.
The project started in January 2020 and will end on 31st November 2024.
The main contact for the project is Marie Coors.
The recruitment of the hospitals started on 1st June 2021. A total of 18 hospitals will participate in the study.