Hip Fractures
Conditions
Brief summary
The International Osteoporosis Foundation (IOF) and the American Society for Bone Research and Mineral Metabolism recommend the creation and implementation of fracture coordination services (FLS) as the most efficient way to address the problem. FLS has emerged as a new clinical approach that uses coordinated, multidisciplinary care to improve post-fracture outcomes and reduce recurrent fractures. It is a multidisciplinary and protocolized care model that must guarantee: 1. Identify fragility fractures and people at risk for a fracture 2. Fracture risk assessment 3. Indication for treatment or referral 4. Improvement in therapeutic compliance 5. Reduce the risk of falls It is known that patients who have undergone a FLS model (vs no FLS), have lower mortality, lower risk of fracture, with a reduction of 35% and 56%, respectively, during two years of follow-up. One of the most important objectives of the FLS is the proper recognition and treatment of osteoporosis (OP) in patients with fragility fractures. A major problem is the lack of adherence to treatment for OP, and inclusion in an FLS program increases the prescription of bisphosphonates from 17.9% to 76%. In addition, a specific follow-up program means that 73% of patients followed by FLS continue to undergo anti-resorptive treatment after 2 years of having suffered a femur fracture.
Detailed description
Hypothesis After a femur fracture due to fragility, upon discharge from surgery at the Hospital de la Santa Creu i Sant Pau, including patients in a regional FLS program will make it possible to complete the study of the patient with fracture, improve adherence to treatment of OP (secondary prevention), and obtain better functional recovery.
Interventions
OTHERFracture Territorial Liaison Service afert a Hip fracture
Give a diferent than the current one way of follow up to the patients with hip fracture
Sponsors
Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Multicenter clinical trial. Adult patients who consult the Hospital Emergency Department (ED) of the Hospital de la Santa Creu i Sant Pau (HSCSP) for an FxF PSM as a primary or secondary diagnosis will be selected and will be randomized with a 1:1 distribution to be included in the FLS -CTSPau (intervention group) or to receive usual care (control group). The result of the intervention will be evaluated in terms of health outcomes (re-consultations, hospital readmissions and quality of life).
Eligibility
Sex/Gender
ALL
Age
65 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* All hip fractures older than 65 years
Exclusion criteria
* Politraumatic fractures * Metastasic fractures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Deaths | 1 year after discharge | % of Number of deaths after 1st year o follow up |
| Number of Falls | 1 year after discharge | Number of Falls 1st year o follow up |
| Percentage of patients with adequated Osteoporotic treatment | 1 year after discharge | Percentage of patients with adequated osteoporotic treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Barthel at the end of follow up | 1 year after discharge | Compare Barthel after hospital discharge with the end of follow up barthel. Minimum is 0 maximum is 100. |
Countries
Spain
Contacts
Primary ContactJordi M Marcuello, Doctor
Outcome results
None listed