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Experience of a systematic approach to care and prevention of fragility fractures in New Zealand

Experience of a systematic approach to care and prevention of fragility fractures in New Zealand
Experience of a systematic approach to care and prevention of fragility fractures in New Zealand
Summary: this narrative review describes efforts to improve the care and prevention of fragility fractures in New Zealand from 2012 to 2022. This includes development of clinical standards and registries to benchmark provision of care, and public awareness campaigns to promote a life-course approach to bone health.

Purpose: this review describes the development and implementation of a systematic approach to care and prevention for New Zealanders with fragility fractures, and those at high risk of first fracture. Progression of existing initiatives and introduction of new initiatives are proposed for the period 2022 to 2030.

Methods: in 2012, Osteoporosis New Zealand developed and published a strategy with objectives relating to people who sustain hip and other fragility fractures, those at high risk of first fragility fracture or falls and all older people. The strategy also advocated formation of a national fragility fracture alliance to expedite change.

Results: in 2017, a previously informal national alliance was formalised under the Live Stronger for Longer programme, which includes stakeholder organisations from relevant sectors, including government, healthcare professionals, charities and the health system. Outputs of this alliance include development of Australian and New Zealand clinical guidelines, clinical standards and quality indicators and a bi-national registry that underpins efforts to improve hip fracture care. All 22 hospitals in New Zealand that operate on hip fracture patients currently submit data to the registry. An analogous approach is ongoing to improve secondary fracture prevention for people who sustain fragility fractures at other sites through nationwide access to Fracture Liaison Services.

Conclusion: widespread participation in national registries is enabling benchmarking against clinical standards as a means to improve the care of hip and other fragility fractures in New Zealand. An ongoing quality improvement programme is focused on eliminating unwarranted variation in delivery of secondary fracture prevention.
Fracture liaison service, Fragility fracture, Registry, Systematic approach
1862-3522
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Mlotek, Anastasia Soulié
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Harris, Roger
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Gill, Christine Ellen, Mitchell, Paul, Clark, Jan, Cornish, Jillian, Fergusson, Peter, Gilchrist, Nigel, Hayman, Lynne, Hornblow, Sue, Kim, David, Mackenzie, Denise, Milsom, Stella, von Tunzelmann, Adrienne, Binns, Elizabeth, Fergusson, Kim, Flemming, Stewart, Hurring, Sarah, Lilley, Rebbecca, Miller, Caroline, Navarre, Pierre, Pettett, Andrea, Sankaran, Shankar, Seow, Min Yee, Sincock, Jenny, Ward, Nicola, Wright, Mark, Close, Jacqueline C.T., Harris, Ian, Armstrong, Elizabeth, Hallen, Jamie, Hikaka, Joanna, Kerse, Ngaire, Vujnovich, Andrea, Ganda, Kirtan, Seibel, Markus Joachim, Jackson, Thomas, Kennedy, Paul, Malpas, Kirsten, Dann, Leona, Shuker, Carl, Dunne, Colleen, Wood, Philip, Magaziner, Jay, Marsh, David, Tabu, Irewin, Cooper, Cyrus, Halbout, Philippe, Javaid, Muhammad Kassim, Akesson, Kristina E., Mlotek, Anastasia Soulié, Bruele-Champagne, Eric and Harris, Roger (2022) Experience of a systematic approach to care and prevention of fragility fractures in New Zealand. Archives of Osteoporosis, 17 (1), [108]. (doi:10.1007/s11657-022-01138-1).

Record type: Review

Abstract

Summary: this narrative review describes efforts to improve the care and prevention of fragility fractures in New Zealand from 2012 to 2022. This includes development of clinical standards and registries to benchmark provision of care, and public awareness campaigns to promote a life-course approach to bone health.

Purpose: this review describes the development and implementation of a systematic approach to care and prevention for New Zealanders with fragility fractures, and those at high risk of first fracture. Progression of existing initiatives and introduction of new initiatives are proposed for the period 2022 to 2030.

Methods: in 2012, Osteoporosis New Zealand developed and published a strategy with objectives relating to people who sustain hip and other fragility fractures, those at high risk of first fragility fracture or falls and all older people. The strategy also advocated formation of a national fragility fracture alliance to expedite change.

Results: in 2017, a previously informal national alliance was formalised under the Live Stronger for Longer programme, which includes stakeholder organisations from relevant sectors, including government, healthcare professionals, charities and the health system. Outputs of this alliance include development of Australian and New Zealand clinical guidelines, clinical standards and quality indicators and a bi-national registry that underpins efforts to improve hip fracture care. All 22 hospitals in New Zealand that operate on hip fracture patients currently submit data to the registry. An analogous approach is ongoing to improve secondary fracture prevention for people who sustain fragility fractures at other sites through nationwide access to Fracture Liaison Services.

Conclusion: widespread participation in national registries is enabling benchmarking against clinical standards as a means to improve the care of hip and other fragility fractures in New Zealand. An ongoing quality improvement programme is focused on eliminating unwarranted variation in delivery of secondary fracture prevention.

Text
New Zealand Systematic Approach 2012-2022 - Revision - Accepted - Accepted Manuscript
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More information

Accepted/In Press date: 7 May 2022
Published date: 2 August 2022
Additional Information: Funding Information: Osteoporosis New Zealand would like to thank the numerous healthcare professionals and colleagues from the government, not-for-profit and healthcare administration sectors in New Zealand, Australia and further afield who have contributed to this body of work during the last decade. In particular, we thank Osteoporosis New Zealand’s advisors, Dr. Michael Nowitz, Dr. Susannah O’Sullivan, Distinguished Professor Ian Reid CNZM and Dr. Jacob Munro, and Dr. Hannah Seymour (President, Fragility Fracture Network), for their encouragement and support. Osteoporosis New Zealand would also like to acknowledge the support of ACC, which enabled licencing of Know your Bones™ from Osteoporosis Australia (which rebranded as Healthy Bones Australia during 2021) and development of the national quality improvement programme for Fracture Liaison Services. We also thank Mediaworks NZ for the grant to air the Bone Health New Zealand TV commercial. Furthermore, very generous pro-bono support from Osteoporosis New Zealand’s agency Deep Ltd., in combination with colleagues at The Rig and Factory Studios, made it possible to produce the television commercial at a fraction of standard costs. Publisher Copyright: © 2022, International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.
Keywords: Fracture liaison service, Fragility fracture, Registry, Systematic approach

Identifiers

Local EPrints ID: 469234
URI: http://eprints.soton.ac.uk/id/eprint/469234
ISSN: 1862-3522
PURE UUID: c1d1c882-db7e-4dcd-b048-24f2c7a6340a
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 09 Sep 2022 16:45
Last modified: 18 Mar 2024 05:07

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Contributors

Author: Christine Ellen Gill
Author: Paul Mitchell
Author: Jan Clark
Author: Jillian Cornish
Author: Peter Fergusson
Author: Nigel Gilchrist
Author: Lynne Hayman
Author: Sue Hornblow
Author: David Kim
Author: Denise Mackenzie
Author: Stella Milsom
Author: Adrienne von Tunzelmann
Author: Elizabeth Binns
Author: Kim Fergusson
Author: Stewart Flemming
Author: Sarah Hurring
Author: Rebbecca Lilley
Author: Caroline Miller
Author: Pierre Navarre
Author: Andrea Pettett
Author: Shankar Sankaran
Author: Min Yee Seow
Author: Jenny Sincock
Author: Nicola Ward
Author: Mark Wright
Author: Jacqueline C.T. Close
Author: Ian Harris
Author: Elizabeth Armstrong
Author: Jamie Hallen
Author: Joanna Hikaka
Author: Ngaire Kerse
Author: Andrea Vujnovich
Author: Kirtan Ganda
Author: Markus Joachim Seibel
Author: Thomas Jackson
Author: Paul Kennedy
Author: Kirsten Malpas
Author: Leona Dann
Author: Carl Shuker
Author: Colleen Dunne
Author: Philip Wood
Author: Jay Magaziner
Author: David Marsh
Author: Irewin Tabu
Author: Cyrus Cooper ORCID iD
Author: Philippe Halbout
Author: Muhammad Kassim Javaid
Author: Kristina E. Akesson
Author: Anastasia Soulié Mlotek
Author: Eric Bruele-Champagne
Author: Roger Harris

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