Experience of a systematic approach to care and prevention of fragility fractures in New Zealand,Archives of Osteoporosis

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Experience of a systematic approach to care and prevention of fragility fractures in New Zealand
Archives of Osteoporosis ( IF 3 ) Pub Date : 2022-08-02 , DOI: 10.1007/s11657-022-01138-1
Christine Ellen Gill _{1,

2} , Paul James Mitchell _{1,

2,

3,

4,

5} , Jan Clark ₁ , Jillian Cornish _{1,

6,

7} , Peter Fergusson ₁ , Nigel Gilchrist _{1,

8} , Lynne Hayman ₁ , Sue Hornblow ₁ , David Kim _{1,

2,

7,

9} , Denise Mackenzie _{1,

2} , Stella Milsom _{1,

10,

11,

12} , Adrienne von Tunzelmann ₁ , Elizabeth Binns _{13,

14,

15} , Kim Fergusson _{2,

14,

16,

17} , Stewart Fleming _{2,

14,

18} , Sarah Hurring _{14,

19} , Rebbecca Lilley _{14,

20} , Caroline Miller ₁₄ , Pierre Navarre _{14,

21,

22,

23} , Andrea Pettett _{14,

23} , Shankar Sankaran _{1,

14} , Min Yee Seow _{9,

14,

24} , Jenny Sincock _{14,

25} , Nicola Ward _{2,

14,

26} , Mark Wright _{14,

23,

27} , Jacqueline Clare Therese Close _{28,

29,

30} , Ian Andrew Harris _{28,

31} , Elizabeth Armstrong _{32,

33} , Jamie Hallen ₃₂ , Joanna Hikaka _{2,

34} , Ngaire Kerse _{2,

35} , Andrea Vujnovich _{2,

36} , Kirtan Ganda _{37,

38,

39} , Markus Joachim Seibel _{37,

40,

41} , Thomas Jackson _{14,

42} , Paul Kennedy ₄₂ , Kirsten Malpas _{2,

42} , Leona Dann _{2,

43} , Carl Shuker ₄₃ , Colleen Dunne ₄₄ , Philip Wood _{9,

14,

44} , Jay Magaziner _{5,

45} , David Marsh ₅ , Irewin Tabu _{5,

46,

47} , Cyrus Cooper _{48,

49,

50,

51} , Philippe Halbout ₄₈ , Muhammad Kassim Javaid _{4,

48} , Kristina Åkesson _{48,

52,

53} , Anastasia Soulié Mlotek ₄₈ , Eric Brûlé-Champagne ₄₈ , Roger Harris _{1,

2,

14}

Affiliation

Osteoporosis New Zealand, Wellington, New Zealand.
New Zealand Implementation and Management Committee, Australian and New Zealand Fragility Fracture Registry, Wellington, New Zealand.
School of Medicine, University of Notre Dame Australia, Sydney Campus, 128-140 Broadway, Chippendale, Sydney, NSW, 2007, Australia.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Fragility Fracture Network, c/o MCI Schweiz AG, Zürich, Switzerland.
Bone and Joint Research Laboratory, Department of Medicine, University of Auckland, Auckland, New Zealand.
Australian and New Zealand Bone and Mineral Society, Sydney, Australia.
CGM Research Trust, 40 Stewart Street, Christchurch, New Zealand.
Waitemata District Health Board, Auckland, New Zealand.
Fertility Associates, Auckland, New Zealand.
Auckland District Health Board, Auckland, New Zealand.
Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand.
New Zealand Implementation and Management Committee, Australian and New Zealand Hip Fracture Registry, Wellington, New Zealand.
Physiotherapy New Zealand, Wellington, New Zealand.
Fracture Liaison Network New Zealand, Wellington, New Zealand.
Fracture Liaison Service, Marlborough District Health Board, Nelson, Nelson, New Zealand.
OperaIT Data Services, Logan, Queensland, Australia.
Older Persons' Health Specialist Service, Canterbury District Health Board, Christchurch, New Zealand.
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Southland Hospital, Invercargill, New Zealand.
University of Otago, Dunedin, New Zealand.
New Zealand Orthopaedic Association, Wellington, New Zealand.
Australian and New Zealand Society for Geriatric Medicine, Sydney, NSW, Australia.
Canterbury District Heath Board, Christchurch, New Zealand.
Bay of Plenty District Health Board, Tauranga, New Zealand.
Department of Orthopaedic Surgery, Auckland City Hospital, Auckland, New Zealand.
Australian and New Zealand Hip Fracture Registry Steering Group, Sydney, Australia.
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.
Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.
Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, NSW, Australia.
Australian Hip Fracture Registry, Neuroscience Research Australia, Sydney, NSW, Australia.
School of Population Health, University of New South Wales, Sydney, Australia.
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
School of Population Health, University of Auckland, Auckland, New Zealand.
Auckland University of Technology, Auckland, New Zealand.
Australian and New Zealand Fragility Fracture Registry Steering Group, Sydney, Australia.
Department of Endocrinology, Concord Hospital, Concord, NSW, Australia.
Concord Clinical School, The University of Sydney, Sydney, NSW, Australia.
Bone Research Program, ANZAC Research Institute, Concord, NSW, Australia.
Faculty of Medicine and Health, Sydney Medical School at Concord Campus, The University of Sydney, Sydney, NSW, Australia.
Accident Compensation Corporation, Wellington, New Zealand.
Health Quality & Safety Commission New Zealand, Wellington, New Zealand.
Ministry of Health, Wellington, New Zealand.
University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Orthopedics, University of the Philippines - Philippine General Hospital, Manila, Philippines.
Institute on Aging-National Institutes of Health, UP Manila, Manila, Philippines.
International Osteoporosis Foundation, Nyons, Switzerland.
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
Department of Clinical Sciences, Lund University, Malmö, Sweden.
Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden.

Summary

This narrative review describes efforts to improve the care and prevention of fragility fractures in New Zealand from 2012 to 2022. This includes development of clinical standards and registries to benchmark provision of care, and public awareness campaigns to promote a life-course approach to bone health.

Purpose

This review describes the development and implementation of a systematic approach to care and prevention for New Zealanders with fragility fractures, and those at high risk of first fracture. Progression of existing initiatives and introduction of new initiatives are proposed for the period 2022 to 2030.

Methods

In 2012, Osteoporosis New Zealand developed and published a strategy with objectives relating to people who sustain hip and other fragility fractures, those at high risk of first fragility fracture or falls and all older people. The strategy also advocated formation of a national fragility fracture alliance to expedite change.

Results

In 2017, a previously informal national alliance was formalised under the Live Stronger for Longer programme, which includes stakeholder organisations from relevant sectors, including government, healthcare professionals, charities and the health system. Outputs of this alliance include development of Australian and New Zealand clinical guidelines, clinical standards and quality indicators and a bi-national registry that underpins efforts to improve hip fracture care. All 22 hospitals in New Zealand that operate on hip fracture patients currently submit data to the registry. An analogous approach is ongoing to improve secondary fracture prevention for people who sustain fragility fractures at other sites through nationwide access to Fracture Liaison Services.

Conclusion

Widespread participation in national registries is enabling benchmarking against clinical standards as a means to improve the care of hip and other fragility fractures in New Zealand. An ongoing quality improvement programme is focused on eliminating unwarranted variation in delivery of secondary fracture prevention.

中文翻译：

新西兰脆性骨折护理和预防系统方法的经验

概括

这篇叙述性评论描述了 2012 年至 2022 年新西兰为改善脆性骨折的护理和预防所做的努力。这包括制定临床标准和登记以基准提供护理，以及开展公众意识运动以促进骨骼健康的生命全程方法.

目的

本综述描述了针对患有脆性骨折和首次骨折高风险人群的系统性护理和预防方法的开发和实施。提议在 2022 年至 2030 年期间推进现有举措并引入新举措。

方法

2012 年，新西兰骨质疏松症制定并发布了一项战略，其目标涉及患有髋部骨折和其他脆性骨折的人群、首次发生脆性骨折或跌倒的高风险人群以及所有老年人。该战略还提倡组建全国脆弱性骨折联盟以加速变革。

结果

2017 年，以前非正式的全国联盟在“活得更久”计划下正式成立，其中包括来自相关部门的利益相关者组织，包括政府、医疗保健专业人员、慈善机构和卫生系统。该联盟的成果包括制定澳大利亚和新西兰的临床指南、临床标准和质量指标，以及支持改善髋部骨折护理工作的双边登记。新西兰所有 22 家对髋部骨折患者进行手术的医院目前都向登记处提交数据。一种类似的方法正在通过全国范围内的骨折联络服务来改善在其他部位发生脆性骨折的人的二级骨折预防。