Establishing Fracture Liaison Services is the Key to Addressing Gaps in Secondary Fragility Fracture Prevention Care

Fracture Liaison Services (FLS), that provide assessment, treatment and follow up to fracture patients using a multidisciplinary approach, have been shown to improve the care for fragility fracture patients in Malaysia and should be consolidated and expanded to provide care to individuals throughout the country. 

Fragility fractures, often resulting from low-impact injuries, become increasingly common as we age. These fractures can double the risk of experiencing another fracture in one's lifetime, with the highest risk occurring within 18 months of the initial fracture. Unfortunately, many patients do not receive proper risk assessments and interventions to reduce this risk. This is where the Fracture Liaison Service (FLS) steps in to bridge the gap in treatment. 

In Malaysia, a scoping review by Lim et al delved into the role of FLS services in Malaysia. FLS services are multidisciplinary in nature, involving various departments such as orthopedics, osteoporosis expertise, bone densitometry, rehabilitation, falls services, and primary care. These services are coordinated to provide comprehensive care for patients, including assessment, treatment, and follow-up. The review explored the current state of FLS services in Malaysia, noting that while there are 12 FLS services primarily located in the Klang Valley (an urban sector of Malaysia), coverage remains limited, and many Malaysians lack access to these services. 

The study also discussed the organization and delivery of FLS services, including team composition and patient eligibility criteria. Furthermore, it highlighted the impact of FLS, with one public hospital reporting increased BMD assessments (by about 2 to 3 folds) and medication adherence. It also emphasized the consensus among local experts and national guidelines supporting the expansion of FLS services and the need for a multidisciplinary approach. For instance, the Fragility Fracture Network Malaysia was established to improve the care for people with fragility fractures by prioritizing secondary fragility fracture prevention and promoting the role of the FLS. 

The study called for the consolidation of existing FLS services and the development of new ones to address the secondary fracture prevention gap in Malaysia. It stresses the importance of public awareness, research, and advocacy by specialist societies to make FLS a part of national policy and improve fracture prevention efforts. And finally, as stated in the study, “FLS services will be the key to address the secondary fracture prevention gap in Malaysia.”

Read the article here!