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Fracture liaison services for osteoporosis in the Asia-Pacific region: current unmet needs and systematic literature review
- Source :
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 29(4)
- Publication Year :
- 2017
-
Abstract
- The analysis aimed to identify the treatment gaps in current fracture liaison services (FLS) and to provide recommendations for best practice establishment of future FLS across the Asia-Pacific region. The findings emphasize the unmet need for the implementation of new programs and provide recommendations for the refinement of existing ones. The study’s objectives were to evaluate fracture liaison service (FLS) programs in the Asia-Pacific region and provide recommendations for establishment of future FLS programs. A systematic literature review (SLR) of Medline, PubMed, EMBASE, and Cochrane Library (2000–2017 inclusive) was performed using the following keywords: osteoporosis, fractures, liaison, and service. Inclusion criteria included the following: patients ≥ 50 years with osteoporosis-related fractures; randomized controlled trials or observational studies with control groups (prospective or retrospective), pre–post, cross-sectional and economic evaluation studies. Success of direct or indirect interventions was assessed based on patients’ understanding of risk, bone mineral density assessment, calcium intake, osteoporosis treatment, re-fracture rates, adherence, and mortality, in addition to cost-effectiveness. Overall, 5663 unique citations were identified and the SLR identified 159 publications, reporting 37 studies in Asia-Pacific. These studies revealed the unmet need for public health education, adequate funding, and staff resourcing, along with greater cooperation between departments and physicians. These actions can help to overcome therapeutic inertia with sufficient follow-up to ensure adherence to recommendations and compliance with treatment. The findings also emphasize the importance of primary care physicians continuing to prescribe treatment and ensure service remains convenient. These findings highlight the limited evidence supporting FLS across the Asia-Pacific region, emphasizing the unmet need for new programs and/or refinement of existing ones to improve outcomes. With the continued increase in burden of fractures in Asia-Pacific, establishment of new FLS and assessment of existing services are warranted to determine the impact of FLS for healthcare professionals, patients, family/caregivers, and society.
- Subjects :
- medicine.medical_specialty
Asia
Endocrinology, Diabetes and Metabolism
Best practice
Cost-Benefit Analysis
MEDLINE
Psychological intervention
030209 endocrinology & metabolism
Cochrane Library
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
Patient Education as Topic
law
Recurrence
Medicine
Humans
030212 general & internal medicine
Australasia
Bone Density Conservation Agents
business.industry
Delivery of Health Care, Integrated
Health Care Costs
Systematic review
Family medicine
Economic evaluation
Osteoporosis
Observational study
business
Needs Assessment
Osteoporotic Fractures
Program Evaluation
Subjects
Details
- ISSN :
- 14332965
- Volume :
- 29
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
- Accession number :
- edsair.doi.dedup.....d76b12c719a837d8ea74a0848ed023d7