Alberta’s Hip Fracture Prevention Model Showcased on Osteoporosis Canada’s New Registry

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Liz Evens, ABJHI Program Manager Alberta's FLS targets and treats the underlying causes of hip fracture

Liz Evens, ABJHI Program Manager
“Alberta’s FLS targets and treats the underlying causes of hip fracture”

An Alberta program coordinated by ABJHI has been recognized by Osteoporosis Canada for its demonstrated commitment to helping Albertans who have had a hip fracture prevent another fall and fracture.

The program, launched in Alberta in 2015 by Alberta Health Services’ Bone and Joint Health Strategic Clinical Network (BJH SCN), is modelled on Osteoporosis Canada’s Fracture Liaison Services (FLS). It was introduced first at Edmonton’s Misericordia Hospital and Calgary’s Peter Lougheed Centre and expanded in early 2016 to the Red Deer Regional Hospital. Further expansion is coming.

Alberta’s FLS is showcased on Osteoporosis Canada’s new FLS Registry, which was launched to profile hospitals across Canada that have implemented effective FLS programs.

“We need to break the cycle of recurrent and debilitating fractures due to osteoporosis,” Dr. Diane Theriault, Osteoporosis Canada’s Chief Scientific Officer for FLS, said. “We congratulate the Bone and Joint Health Strategic Clinical Network and ABJHI for having implemented FLS meeting all of the criteria for inclusion in our registry. By ensuring fracture patients receive the osteoporosis care they need, the program will help make Albertans’ first break their last.”

Like the Osteoporosis Canada FLS model, Alberta’s FLS is a “3i” program comprising identification, investigation and initiation of treatment. Anyone age 50 or older who enters a participating hospital with a fractured hip is assigned a dedicated team consisting of a registered nurse and physician. The team does a comprehensive assessment of these patients for osteoporosis and geriatric-related medical conditions that put them at risk of falling and fracturing again. Osteoporosis medication is initiated as needed, and patients are referred to services, such as fall prevention and memory improvement programs, that help reduce their risk.

The team follows each patient for 12 months with the nurse serving as case manager coordinating referrals to other health professionals, ensuring patients are complying with their treatment regimen, and monitoring for medication side effects. At 12 months, management of the patient’s condition is transferred to a family physician.

In addition to coordinating the FLS rollout in Alberta, ABJHI is gathering and analyzing data on the program’s performance as part of a continuous improvement effort.

For every 100 hip fracture patients assessed through FLS:

    • 4 hip fractures prevented
    • Devastating loss of quality of life avoided
    • Riks of mortality significantly reduced
    • $260,000 in public health care costs avoided

These benefits come at a program cost of just $56 per patient.