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New review sets international standards for best practice in fracture liaison services

Fragility fractures due to osteoporosis are a major cause of disability or premature death in older adults. Those at highest risk are patients who have already suffered one fragility fracture; they are at twice the risk of suffering a future fracture compared to others who have not fractured.

Nevertheless health care systems around the world are failing to identify and treat these patients, leaving them exposed to debilitating and life-threatening secondary fractures.

Based on evidence from numerous global studies, a new report, 'Capture the Fracture: A Best Practice Framework and Global Campaign to Break the Fragility Fracture Cycle' (1), sets 13 achievable standards for best practice in implementing fracture liaison services (FLS) worldwide, in a broad range of health-economic environments.

The report has been published in the peer-reviewed journal 'Osteoporosis International' and is endorsed by the International Osteoporosis Foundation (IOF) Committee of Scientific Advisors. It is available at

Fracture Liaison Systems help reduce the burden of fragility fractures:

Professor Cyrus Cooper, Chair of the IOF Committee of Scientific Advisors (CSA) emphasized the importance of systematic and coordinated secondary prevention care: "Coordinator-based FLS have been shown to close the gap in secondary fracture prevention care, ensuring that fragility fracture sufferers receive appropriate assessment and intervention to reduce future fracture risk."

The best practice framework sets the foundation for 'Capture the Fracture', a multi-stakeholder initiative led by the International Osteoporosis Foundation. The initiative hopes to drive change so that secondary fracture prevention becomes a reality around the world.

The new initiative aims to:

  • Illustrate global best practice for FLS;
  • Set benchmarks to which clinics and hospitals can aspire;
  • Provide essential resources and documentation;
  • Give international recognition to FLS programmes around the world;
  • Establish mentoring and grant programmes to assist development of FLS at the local level.

Clinics and hospitals worldwide can participate by submitting information about their FLS or coordinator- based programmes for inclusion on The portal offers a visual map that shows the address and location of clinics around the world offering FLS, along with a summary of their achievements in secondary fracture prevention; the map can be viewed at:

Professor Kristina Akesson, first author of the review and Chair of the Capture the Fracture initiative, stated, "Due to the increase in the proportion of seniors worldwide, we're expecting a dramatic increase in the health-economic costs associated with osteoporotic fractures in the coming years. The implementation of effective FLS systems are the best way for the health care community to identify and manage people at high risk of secondary fractures. Such systems will play a critical role in reducing the enormous human and health-economic costs of fractures."


Contact: L. Misteli
International Osteoporosis Foundation

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