Refracture Prevention

Secondary Fracture Prevention

Patients who suffer a minimal trauma fracture due to osteoporosis have a significantly greater risk of having a subsequent fracture. This problem is compounded by the fact that only around 20% of patients who come to medical attention with an osteoporotic fracture are investigated and treated for osteoporosis. The healthcare system is treating the fracture, but not routinely investigating the underlying cause. 
Secondary fracture prevention services are an effective way of combating this health issue. These services capture minimal trauma fracture patients and have been proven in Australia and overseas. In the last decade over 175 clinical papers pertaining to secondary fracture prevention services have been published which endorse the service. Secondary fracture prevention services (SFPS) offer a proven, effective way to capture people at risk of secondary fractures and prevent further fractures.

Secondary Fracture Prevention Services (SFPS) – aims and service structure

SFPS are usually delivered by a Clinical Nurse Specialist supported by a Lead Clinician in Osteoporosis. The Clinical Nurse Specialist identifies patients with new fragility fractures who are either admitted as an orthopaedic inpatient or who are managed as outpatients through the fracture clinic. Appropriate candidates are referred to the “one stop” SFPS clinic, where bone density is measured to assess future fracture risk. Treatment for secondary fracture prevention is initiated by the SFPS clinician based on the level of future fracture risk, and falls prevention services are recommended where appropriate. Long-term management plans are agreed by protocol with local general practice.
Osteoporosis Australia supports this model, which already operates in an ad hoc way across selected hospitals within most states. The aim is to achieve greater uniformity of this system and  gain federal and state government  support for this important fracture prevention approach. 
The International Osteoporosis Foundation is also a strong supporter of this model and tracks success around the world in introducing secondary fracture prevention services. This model is supported by key clinicians both domestically and internationally as an effective and proven approach to reducing secondary fracture rates and capturing osteoporotic and at-risk patients.

Author: Osteoporosis Australia Medical & Scientific Advisory Committee
Last updated: 06/18/2015 - 12:14