ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020
A patient-level key performance indicator set to measure the effectiveness of fracture liaison services and guide quality improvement: a position paper of the IOF Capture the Fracture Working Group, National Osteoporosis Foundation and Fragility Fracture Network.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 4 of them syntheses that pooled it.
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Who cites it
66 citing papers in PubMed, 4 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- [Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research].Wiener klinische Wochenschrift · 2024Guideline
- The integrated structure of care: evidence for the efficacy of models of clinical governance in the prevention of fragility fractures after recent sentinel fracture after the age of 50 years.Archives of osteoporosis · 2023Pooled it
- Short- and long-term prognostic factors associated with functional recovery in elderly patients with hip fracture: A systematic review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Pooled it
- Association of orthogeriatric care models with evaluation and treatment of osteoporosis: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Pooled it
- Position paper: a coordinated approach to fracture and fall prevention from seven international organizations.European geriatric medicine · 2026Article
- Preventing Hip (Proximal Femoral) Fractures: An Evidence-Based Review for Clinicians.Journal of clinical medicine · 2026Review
- Improved Barthel Index Speed Is a Prognostic Indicator of Secondary Complications following Hip Hemiarthroplasty in Femoral Neck Fractures.Hip & pelvis · 2026Article
- DXA in post-fracture care: gatekeeper or facilitator?Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Impact of a national reimbursement add-on policy on refracture risk and secondary fracture prevention after hip fracture in Japan: a population-based interrupted time series analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Factors influencing the implementation of best clinical practices for hip fracture management in resource-constrained hospitals in China and co-design of quality improvement interventions: a qualitative study.The Lancet regional health. Western Pacific · 2026Article
- Beyond the fracture: coordinated action for bone health equity in Africa.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Fracture liaison services: successful implementation in Belgium using a regional healthcare quality improvement initiative.Archives of osteoporosis · 2026Article
- Digitally enhanced fracture liaison service in Austria-a feasibility analysis.Archives of osteoporosis · 2026Article
- Osteoporosis treatment indications following fracture: identifying relevant fracture sites for Fracture Liaison Services.Archives of osteoporosis · 2026Article
- Perspective: Fragility Fracture Network in the Nordic Orthopaedic Federations countries - the role of orthopaedic surgeons.Acta orthopaedica · 2026Article
- Review
- The global, regional, and national burden attributable to low bone mineral density, 1990-2020: an analysis of a modifiable risk factor from the Global Burden of Disease Study 2021.The Lancet. Rheumatology · 2025Article
- Hip fracture and cognitive impairment in older adults-integrated approaches to rehabilitation: a narrative review.Ewha medical journal · 2025Article
- Inpatient rehabilitation fracture liaison service (FLS) improves outcomes for secondary prevention of hip fractures.Bone reports · 2025Article
- Which Patients in the FLS Should Be Prioritised for a DXA Scan Within 12 Weeks?Journal of clinical medicine · 2025Article
6 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors at 7 institutions in 7 countries.
Funding
Abstract
The International Osteoporosis Foundation (IOF) Capture the Fracture® Campaign with the Fragility Fracture Network (FFN) and National Osteoporosis Foundation (NOF) has developed eleven patient-level key performance indicators (KPIs) for fracture liaison services (FLSs) to guide quality improvement.
introductionFracture Liaison Services (FLSs) are recommended worldwide to reduce fracture risk after a sentinel fracture. Given not every FLS is automatically effective, the IOF Capture the Fracture working group has developed and implemented the Best Practice Framework to assess the organisational components of an FLS. We have now developed a complimentary KPI set that extends this assessment of performance to the patient level.
methodsThe Capture the Fracture working group in collaboration with the Fragility Fracture Network Secondary Fragility Fracture Special Interest Group and National Osteoporosis Foundation adapted existing metrics from the UK-based Fracture Liaison Service Database Audit to develop a patient-level KPI set for FLSs.
resultsEleven KPIs were selected. The proportion of patients: with non-spinal fractures; with spine fractures (detected clinically and radiologically); assessed for fracture risk within 12 weeks of sentinel fracture; having DXA assessment within 12 weeks of sentinel fracture; having falls risk assessment; recommended anti-osteoporosis medication; commenced of strength and balance exercise intervention within 16 weeks of sentinel fracture; monitored within 16 weeks of sentinel fracture; started anti-osteoporosis medication within 16 weeks of sentinel fracture; prescribed anti-osteoporosis medication 52 weeks after sentinel fracture. The final KPI measures data completeness for each of the other KPIs. For these indicators, levels of achievement were set at the < 50%, 50-80% and > 80% levels except for treatment recommendation where a level of 50% was used.
conclusionThis KPI set compliments the existing Best Practice Framework to support FLSs to examine their own performance using patient-level data. By using this KPI set for local quality improvement cycles, FLSs will be able to efficiently realise the full potential of secondary fracture prevention and improved clinical outcomes for their local populations.
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