The effectiveness of implementing a fracture liaison service in Egypt: A
quality improvement study.
Abstract
Background: Fractures are one of the major health problems in the older
population, having a significant impact on overall health, and quality
of life. Fracture liaison services (FLS) are recommended as a model of
best practice. Aims: To determine the effectiveness of implementing an
FLS. Design: This was a quality improvement study set in our facility in
Ain Shams University hospitals. Methods: We compared fracture care and
outcomes before and after the implementation of FLS in terms of time to
surgery, length of stay, pre-and postoperative pain scores, depression,
and treatment decisions. We included 130 patients, aging above 60 years
presenting by fracture to the emergency department. Results: We found
that there was a significant reduction in the median time to surgery in
the post FLS group (p value < 0.001), and also a significant
decrease in the mean length of stay in favor of the group post FLS, with
p value < 0.001. But there wasn’t a significant difference
between the two groups regarding the number of patients that underwent
surgical correction, pre-and post-operative pain, or susceptibility to
depression. Conclusion: Since the beginning of our FLS unit, the
preliminary data have been encouraging, with significant reductions in
time to surgery and length of stay. Because there is poor patient
compliance to post-discharge follow-up, we were not able to accurately
measure time to medical clearance and return to previous activity and
functional levels.