Volume 1 – Spring 2013

Fracture Link Newsletter

 

 Volume 1

A focus on strategic integration for fracture reduction

 

The Ontario Osteoporosis Strategy began in 2005 with funding from the Ministry of Health and Long-Term Care to aid in the reduction of hip fractures and osteoporotic fractures throughout Ontario. In the last 7 years we have developed an approach that supports and complements initiatives at the local level throughout the province. During this period, and in our plans for the future, the main focus remains fracture reduction. This newsletter is the first in a series that will provide updates and highlight opportunities for integration and collaboration between agencies and organizations and with Regional Integration Leads (RILs) working within the Ontario Osteoporosis Strategy at Osteoporosis Canada.

Ontario Osteoporosis Strategy team at Osteoporosis Canada

Fracture reduction by the numbers; where are we?

Fracture Clinic Screening Program

The Fracture Clinic Screening Program (FCSP), developed and operated by Osteoporosis Canada in partnership with theOntario Orthopaedic Association and the Ontario College of Family Physicians, is one of the secondary fracture prevention initiatives launched in 2007 to screen fragility fractures and facilitate diagnosis and appropriate care. This coordinator-based program provides osteoporosis screening in an orthopaedic fracture clinic setting by identifying and assessing men and women who have had a fragility fracture – a broken bone from an activity that would not normally cause bone to break, such as a simple slip, trip or fall.

The inaugural screening took place on January 2nd, 2007 at the Ottawa Hospital, General Campus and the numbers,

both in clinic sites and patients screened have grown ever since! Currently the FCSP is operating with 21 Osteoporosis Screening Coordinators (OSCs) working in 38 high volume fracture clinics across the province.

As of March 2013, over 40,000 patients aged 50 and older with a low-trauma fracture, who have visited one of the participating fracture clinic sites, have met with an OSC to discuss bone health and fracture risks.

It was found that almost 70% of the patients participating in the FCSP returned to their family physician to seek advice about their bone health, about half of these patients were sent for a BMD test, and about 23% of patients were found to have started on appropriate care within one year. The FCSP focuses on improved linkages

between fracture clinics, primary care professionals, orthopaedic wards, rehabilitation and long-term care facilities. The program relies on, and is grateful for, the

continued support of the participating hospitals, the orthopaedic champions, fracture clinic staff, managers and clinical directors, who help ensure the successful implementation of the FCSP.

“Our primary focus is to identify fracture clinic patients who have suffered a fragility fracture so we can help prevent future fractures – some of which can be life threatening,”
-says Dr. Osama Gharsaa, Lakeridge Hospital, Oshawa

Evaluation of the FCSP

The evaluation of the Fracture Clinic Screening Program (FCSP) provides information on inputs, process of care and outcomes, with a final goal of ensuring that patient-centered, results-driven care is offered and accessible to the fragility fracture patient. The Evaluation Team for the FCSP (based at St Michael’s Hospital) monitors and evaluates new initiatives within the FCSP. Over the course of the last year, the Evaluation Team has monitored the implementation of the Bone Mineral Density (BMD) Fast Track program, an initiative implemented at selected sites in order to facilitate patients’ access to BMD testing. The Team compared the outcomes of the patients who went through the BMD Fast Track program with the outcomes of similar patients (matched for age, fracture type and gender) who were screened at non-BMD Fast Track sites (within the FCSP) and found that:

  • 96% of the BMD Fast Track patients had a BMD test completed by follow-up vs. 63% in the matched comparison group.
  • 51% of the BMD Fast Track patients discussed the results of their BMD test with their family physician vs. 25% in the matched comparison group.
  • 33% of the BMD Fast Track patients were prescribed medication for their osteoporosis, osteopenia or low bone density vs. 21% in the matched comparison group.

The 104% increase in knowledge of BMD results (25% to 51%) suggests a more involved or knowledgeable patient able to begin to make more informed treatment choice. The 50% percent increase in treatment prescription rate (21% to 33%) illustrates the positive impact of facilitating BMD testing on treatment rates.

Fracture reduction by the numbers; where are we?

Upcoming Events

Publication Education Forum

November 7th at St. Georges Hall, Waterloo

  • Keynote speaker Dr. Nadira Husein will discuss the most current information on osteoporosis and fracture risk assessment
  • Cathie Tan OT will provide guidance on how to safely do our daily activities such as making the bed

Learn about self management of health, safe physical activity and more
Contact: Kate Harvey
kharvey@osteoporosis.ca
519-500-1440 for more information

Bone Fit™

September 7 & 8, 2013
Toronto, Ontario – Women’s College Hospital
Early Registration Fee: $375 (until August 15th, 2013)
Register online at http://www.bonefit.ca

October 19 & 20, 2013
Ottawa, Ontario – Altum Health Clinic
Early Registration Fee: $175 and $375 (until October 2nd, 2013)
Register online at http://www.bonefit.ca