The Asia -Pacific Bone Academy (APBA) Fracture Liaison Service (FLS) Focus Group educational initiative has stimulated activity across the Asia -Pacific region with the intention of supporting widespread implementation of new FLS. In 2017, the APBA FLS Focus Group developed a suite of tools to support implementation of FLS across the Asia-Pacific region as a component of a multi-faceted educational initiative. This article puts this initiative into context with a narrative review describing the burden of fragility fractures in the region, the current secondary fracture prevention care gap and a summary of emerging best practice. The results of a survey to evaluate the impact of the APBA educational initiative is presented, in addition to commentary on recent activities intended to improve the care of individuals who sustain fragility fractures across the Asia -Pacific. A FLS Toolbox for Asia-Pacific was developed which included the following sections:1. The burden of fragility fractures in the Asia-Pacific region.2. A summary of evidence for FLS in the Asia-Pacific.3. A generic, fully referenced FLS business plan template.4. Potential cost savings accrued by each country, based on a country-specific FLS Benefits Calculator.5. How to start and expand FLS programmes in the Asia-Pacific context.6. A step-by-step guide to setting up FLS in countries in the Asia-Pacific region.7. Other practical tools to support FLS establishment.8. FLS online resources and publications.The FLS Toolbox was provided as a resource to support FLS workshops immediately following the 5th Scientific Meeting of the Asian Federation of Osteoporosis Societies (AFOS) held in Kuala Lumpur in October 2017. The FLS workshops addressed three key themes:• The FLS business case.• Planning the FLS patient pathway.• The role of the FLS coordinator in fragility fracture care management.A follow-up survey of 142 FLS workshop participants was conducted in August-September 2018. The survey included questions regarding how FLS were developed, funded, the scope of service provision and the support provided by the educational initiative. Almost one-third (30.3%) of FLS workshop participants completed the survey. Survey responses were reported for those who had established a FLS at the time the survey was conducted and, separately, for those who had not established a FLS. Findings for those who had established a FLS included:• 78.3% of respondents established a multidisciplinary team to develop the business case for their FLS.• 87.0% of respondents stated that a multidisciplinary team was established to design the patient pathway for their FLS.• 26.1% of respondents stated that their FLS has sustainable funding.• The primary source of funding for FLS was from public hospitals (83.3%) as compared with private hospitals (16.7%).Most hospitals that had not established a FLS at the time the survey was conducted were either in the process of setting-up a FLS (47%) or had plans in place to establish a FLS for which approval is being sought (29%). The primary barrier to establishing a new FLS was lack of sustainable funding. The APBA FLS Focus Group educational initiative has stimulated activity across the Asia-Pacific region with the intention of supporting widespread implementation of new FLS. A second edition of the FLS Toolbox is in development which is intended to complement ongoing efforts throughout the region to expedite widespread implementation of FLS.

中文翻译：

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亚太地区脆性骨折的二级预防：一项教育举措。

亚太骨科学院（APBA）骨折联络处（FLS）焦点小组的教育计划刺激了整个亚太地区的活动，旨在支持广泛实施新的FLS。2017年，APBA FLS焦点小组开发了一套工具来支持在亚太地区实施FLS，这是多方面教育计划的一部分。本文通过叙述性叙述将这一倡议带入了背景，叙述了该地区脆性骨折的负担，当前二级预防骨折的护理差距以及新兴最佳实践的总结。提出了评估APBA教育计划影响的调查结果，除了对近期活动的评论，该活动旨在改善整个亚太地区承受脆弱性骨折的个人的护理。开发了FLS亚太地区工具箱，其中包括以下部分：1。亚太地区的脆性骨折负担2。亚太地区FLS的证据摘要3。通用的，完全引用的FLS业务计划模板4。根据特定国家/地区的FLS收益计算器，每个国家/地区可能节省的费用5。如何在亚太地区启动和扩展FLS计划6。在亚太地区国家/地区建立FLS的分步指南7。支持FLS建立的其他实用工具8。FLS在线资源和出版物。在2017年10月于吉隆坡举行的第五届亚洲骨质疏松学会联合会（AFOS）科学会议之后，立即提供了FLS工具箱作为资源来支持FLS研讨会。FLS研讨会解决了三个关键主题：•FLS商业案例。 •规划FLS患者的路径。•FLS协调员在脆性骨折护理管理中的作用。2018年8月至9月对142位FLS研讨会参与者进行了跟踪调查。该调查包括有关FLS的开发，资金，服务范围和教育计划提供的支持。FLS工作坊参与者中近三分之一（30.3％）完成了调查。报告了在进行调查时已建立FLS的人员的调查回复，另外，对于那些尚未建立FLS的人。已建立FLS的人员的发现包括：•78.3％的受访者建立了一个多学科团队来为其FLS开发业务案例。•87.0％的受访者表示已成立了一个多学科团队来为其FLS设计患者路径。 26.1％的受访者表示，他们的FLS具有可持续的资金。•FLS的主要资金来源来自公立医院（83.3％），而私立医院（16.7％）。当时大多数未建立FLS的医院调查是在建立FLS的过程中进行的（47％），还是已经制定计划以寻求批准的FLS（29％）。建立新的FLS的主要障碍是缺乏可持续的资金。APBA FLS焦点小组的教育计划刺激了整个亚太地区的活动，旨在支持广泛实施新的FLS。FLS工具箱的第二版正在开发中，旨在补充整个地区为加快FLS的广泛实施而进行的工作。