A workshop has been held for hospitals who either have established or are about to establish a fracture liaison service (FLS). The workshop was hosted by the National FLS Steering Group which was established as part of the National Clinical Programme for Trauma and Orthopaedic Surgery (NCPTOS).

The workshop heard the experiences of seven hospitals that are currently delivering an FLS and participating in data collection for the preliminary FLS database report due for publication in October 2022. It also addressed the importance of early interventions in the management of fragility fractures including medication prescription and treatment for osteoporosis, falls education and prevention programmes.

The meeting follows on from the recently published facilities audit of 16 public trauma hospitals which demonstrated that FLS exist in just over half of public trauma hospitals in Ireland.

The audit also showed none of the existing services are capturing all fracture patients; at best, sites identified and managed around 45% of the expected fragility fracture numbers in these centres. It highlights the challenges each site faces due to limited resources of both time and staffing in identifying, treating, educating and monitoring these patients, in line with international standards for FLS. 

'Fragility' or low-trauma fractures are often the first sign of osteoporosis and usually occur as a result of a minor fall. They are one of the leading healthcare costs across Europe. European data suggests an exponential rise in fragility fracture numbers across Europe by 2030; in Ireland the predicted increase is 58%, the highest of all EU countries (Kanis Scope paper).

It is estimated that in Ireland for every one hip fracture there are five associated fragility fractures.

The workshop was chaired by Professor Frances Dockery and Mr Aaron Glynn, the clinical leads for the Fracture Liaison Service Database.

Professor Frances Dockery said: “FLS provide the best method of identifying, treating and monitoring patients who have just sustained a fragility fracture. These services are proven to improve patient treatment rates for secondary fracture prevention, reduce future fracture numbers, and will substantially reduce the cost burden to the health service. FLS exist in 35 countries and have been recommended by the International Osteoporosis Foundation (IOF) as best practice in fracture care. We urgently need a policy to support the national implementation of FLS across Irish trauma hospitals.”