Webinar Slides

73 Pages·2016·5.01 MB·English

Starting a Fracture Liaison Service (FLS) For The
Identification and Treatment of Osteoporosis
Associated Fractures (OAF)
National Bone Health Alliance
Fracture Prevention Central
July 26, 2016

Mary K. Oates, M.D.
Marian Regional Medical Center/Dignity Health
Physical Medicine and Rehabilitation
Certified Clinical Densitometrist (ISCD)
Disclosures for Mary K. Oates, M.D.
 Amgen
 FitTrace
Objectives
 Identify Care Gap for Osteoporosis Associated Fractures
(OAF)
 Identify crucial components necessary
to start an FLS program
 Explore possible alignments within your institution
 Discuss the value of coordinated teamwork in the care of
Osteoporosis Associated Fractures (OAF)
 Describe quality metrics for Osteoporosis Associated
Fractures (OAF) and practical ways to implement them

3
Care Gap for Osteoporosis Associated
Fractures in the US
 10 million Americans have osteoporosis, and 44
million have low bone mass
 In 2005, 2 million Americans suffered Osteoporosis
Associated Fractures for a cost of 17 billion dollars
 Estimates for 2025 are 3 million fractures at cost of 25
billion dollars
 Women account for 71% of the fractures
 Breakdown by skeletal site: 27% vertebrae, 19% wrist,
14% hip, 7% pelvis, 33% other
Suffering a Fragility Fracture Increases the Risk of
an Additional Fracture by 1.5-2.0 times
Approximately 8% of Hip Fracture Patients
Experience a Second Hip Fracture
Fracture Begets Fracture ….if Left Untreated
MEDICA Clinical Performance Measures Report: 2012-2013
Demonstrates Poor Management Compared to Other Diseases
Aggregate Commercial Medicaid Medicare MSHO
Beta Blocker
 88.78%  87.50%  86.00%  90.95%  90.70%
after MI
Breast Cancer
 65.88%  69.28%  58.48%  77.84%  57.93%
Screening
Osteoporosis
Management
 15.11% No data No data  17.73%  12.50%
in Women with
Fracture
 Favorable results compared to previous year
 Unfavorable results compared to previous year
https://www.medica.com/search?q=clinical+performace+measure+2012. Accessed January 30, 2014.
Few Hip Fracture Patients Receive
Osteoporosis Care
 http://www.aarp.org/ppi/info-2016/few-hip-fracture-patients-
receive-osteoporosis-care.html
 by Catherine W. Gillespie (AARP PPI, Health Team), Pamela E.
Morin (OptumLabs), Public Policy Institute, July 18, 2016
 We found that fewer than one in five women ages 50 and older
who experienced a hip fracture between 2008 and 2013 utilized
recommended osteoporosis-related services within 6
months following their fractures. The age-related disparities were
stark: women ages 80 and older were 34 percent less likely than
those ages 50 to 79 to receive the recommended services in a
timely manner. Failure to undergo bone density testing or begin
taking osteoporosis drugs within six months of a hip fracture was
associated with a 62 percent increase in risk of a second hip
fracture among women ages 80 and older.
Seize The Opportunity To Act
 “These data indicate the major opportunity afforded
by secondary fracture prevention strategies. By
responding to the first fracture, we can and should
reduce the likelihood of the occurrence of second and
subsequent fractures, particularly of the hip.”
 Fracture Prevention Central
www.nbha.org/fpc/impact-on-health-care-costs
 Close the care gap with a systematic approach called a
Fracture Liaison Service (FLS)