Implementation of osteoporosis guidelines: a survey of five large fracture liaison services in the Netherlands
| Autor: | Bjorn Winkens, M. van der Elst, Paul C. Willems, K. M. B. Huntjens, S.H. van Helden, J.H. Hegeman, Piet Geusens, T. van Geel, M. C. Blonk, Peter R. Brink |
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| Přispěvatelé: | Algemene Heelkunde, Family Medicine, Orthopedie, Interne Geneeskunde, FHML Methodologie & Statistiek, Surgery, RS: CAPHRI School for Public Health and Primary Care, RS: NUTRIM - R2 - Gut-liver homeostasis |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Endocrinology Diabetes and Metabolism Osteoporosis Risk Factors Preventive Health Services medicine Humans Prospective Studies Guideline implementation Aged Netherlands business.industry Guideline adherence Follow up studies virus diseases Guideline Middle Aged medicine.disease Practice Guidelines as Topic Physical therapy Fracture liaison service Original Article Female Guideline Adherence business Clinical risk factor Fractures Osteoporotic Fractures Follow-Up Studies |
| Zdroj: | Osteoporosis International, 22(7), 2129-2135. Springer-Verlag London Ltd. Osteoporosis International |
| ISSN: | 0937-941X |
| Popis: | Summary Implementation of case findings according to guidelines for osteoporosis in fracture patients presenting at a Fracture Liaison Service (FLS) was evaluated. Despite one guideline, all FLSs differed in the performance of patient selection and prevalence of clinical risk factors (CRFs) indicating the need for more concrete and standardised guidelines. Introduction The aim of the study was to evaluate the implementation of case findings according to guidelines for osteoporosis in fracture patients presenting at FLSs in the Netherlands. Methods Five FLSs were contacted to participate in this prospective study. Patients older than 50 years with a recent clinical fracture who were able and were willing to participate in fracture risk evaluation were included. Performance was evaluated by criteria for patient recruitment, patient characteristics, nurse time, evaluated clinical risk factors (CRFs), bone mineral density (BMD) and laboratory testing and results of CRFs and BMD are presented. Differences between FLSs were analysed for performance (by chi-square and Student’s t test) and for prevalence of CRFs (by relative risks (RR)). Results All FLSs had a dedicated nurse spending 0.9 to 1.7 h per patient. During 39 to 58 months follow-up, 7,199 patients were evaluated (15 to 47 patients/centre/month; mean age, 67 years; 77% women). Major differences were found between FLSs in the performance of patient recruitment, evaluation of CRFs, BMD and laboratory testing, varying between 0% and 100%. The prevalence of CRFs and osteoporosis varied significantly between FLSs (RR between 1.7 and 37.0, depending on the risk factor). Conclusion All five participating FLSs with a dedicated fracture nurse differed in the performance of patient selection, CRFs and in the prevalence of CRFs, indicating the need for more concrete and standardised guidelines to organise evaluation of patients at the time of fracture in daily practice. |
| Databáze: | OpenAIRE |
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