ArticleBMC geriatrics2021
Implementation of an integrated care programme to avoid fragility fractures of the hip in older adults in 18 Bavarian hospitals - study protocol for the cluster-randomised controlled fracture liaison service FLS-CARE.
Article in BMC geriatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Emergency Department Encounters Preceding Hip Fracture in Older Adults: A Window for Future Risk Identification.Journal of the American College of Emergency Physicians open · 2026Article
- Trend in DXA examination rates and the prevalence of osteoporosis in patients with distal radius fractures at a trauma flagship hospital.Archives of osteoporosis · 2026Article
- Mapping the Clinical Care Pathway of Fragility Fracture Patients at a German Maximum Care Provider Through Qualitative Research.Zeitschrift fur Orthopadie und Unfallchirurgie · 2026Article
- Declining hip fracture burden in Sweden 1998-2019 and consequences for projections through 2050.Scientific reports · 2024Article
- A 10-Year Experience of an Integrated Geriatric Hip Fracture Treatment Protocol: Outcomes at a Minimum 2-Year Follow-Up.Geriatric orthopaedic surgery & rehabilitation · 2024Article
- Acceptability and Appropriateness of Patientcentered, Family-focused, Community-oriented (PFC) Lens in the Ortho-Geriatric Fracture Liaison Service among Family and Community Medicine Trainees.Acta medica Philippina · 2024Article
- Reduced Awareness for Osteoporosis in Hip Fracture Patients Compared to Elderly Patients Undergoing Elective Hip Replacement.Medicina (Kaunas, Lithuania) · 2022Article
- Application of machine learning model to predict osteoporosis based on abdominal computed tomography images of the psoas muscle: a retrospective study.BMC geriatrics · 2022Article
- Cost-Effectiveness Analysis of Fracture Liaison Services Compared with Standard of Care in the Secondary Prevention of Fragility Fractures in Spain.ClinicoEconomics and outcomes research : CEOR · 2022Article
- Fragility fractures: proposal of the best practice through the fracture coordination units: the experience of Mexico.Archives of osteoporosis · 2021Review
- The Impact of COVID-19 on the Optimal Management of Osteoporosis.Journal of bone metabolism · 2021Article
- Reduced Awareness for Osteoporosis in Distal Radius Fracture Patients Compared to Patients with Proximal Femur Fractures.Journal of clinical medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundThe economic and public health burden of fragility fractures of the hip in Germany is high. The likelihood of requiring long-term care and the risk of suffering from a secondary fracture increases substantially after sustaining an initial fracture. Neither appropriate confirmatory diagnostics of the suspected underlying osteoporosis nor therapy, which are well-recognised approaches to reduce the burden of fragility fractures, are routinely initiated in the German healthcare system. Therefore, the aim of the study FLS-CARE is to evaluate whether a coordinated care programme can close the prevention gap for patients suffering from a fragility hip fracture through the implementation of systematic diagnostics, a falls prevention programme and guideline-adherent interventions based on the Fracture Liaison Services model.
methodsThe study is set up as a non-blinded, cluster-randomised, controlled trial with unequal cluster sizes. Allocation to intervention group (FLS-CARE) and control group (usual care) follows an allocation ratio of 1:1 using trauma centres as the unit of allocation. Sample size calculations resulted in a total of 1216 patients (608 patients per group distributed over 9 clusters) needed for the analysis. After informed consent, all participants are assessed directly at discharge, after 3 months, 12 months and 24 months. The primary outcome measure of the study is the secondary fracture rate 24 months after initial hip fracture. Secondary outcomes include differences in the number of falls, mortality, quality-adjusted life years, activities of daily living and mobility. DISCUSSION: This study is the first to assess the effectiveness and cost-effectiveness/utility of FLS implementation in Germany. Findings of the process evaluation will also shed light on potential barriers to the implementation of FLS in the context of the German healthcare system. Challenges for the study include the successful integration of the outpatient sector as well as the future course of the coronavirus pandemic in 2020 and its influence on the intervention.
trial registrationGerman Clinical Trial Register (DRKS) 00022237 , prospectively registered 2020-07-09.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.