How to Implement a Fracture Liaison Service

The case for Fracture Liaison Service (FLS) for the prevention of secondary fractures is clear. With an ageing population, the burden of osteoporosis is set to increase. Despite evidence for the clinical effectiveness of secondary fracture prevention, translation in the real world setting remains disappointing: worldwide, eighty per cent of fragility fracture patients are neither assessed nor treated for osteoporosis or falls risk, with the aim of reducing future fracture incidence. If implemented, a wide variety of service models are used to deliver effective secondary fracture prevention. To support and promote the use of effective models of care across the globe, the International Osteoporosis Foundation (IOF) launched the Capture the Fracture® (CTF) programme in 2013. This expert-led and evidence-based programme aims to reduce secondary fractures by facilitating the implementation of FLS on a global level. A primary resource developed by CTF is the Best Practice Framework (BPF), which sets standards for FLS, serves as a benchmark for existing FLS and serves as a guidance tool for developing FLS. In an effort to engage the global medical community, CTF offers a Best Practice Recognition programme where FLS can submit their service to IOF for evaluation against the BPF for a gold, silver or bronze star in recognition of achievements. The FLS is then included in the showcase of best practice and plotted on the CTF Map of Best Practice that displays participating FLS and their respective achievement level. To influence change, the map can be used as a visual representation of FLS available worldwide, their achievements, as well as the areas for opportunity and development in secondary fracture prevention.