The celebration of World Osteoporosis Day was made more significant with the launch of a multi-disciplinary programme aimed at preventing second and subsequent fractures among at-risk patients (the elderly in particular) by a team of doctors from different specializations.

Led by Dr Irewin Tabu of the University of the Philippines - Philippine General Hospital's Department of Orthopedics, the group formally introduced the orthogeriatric Multidisciplinary Fracture Management Model and Fracture Liaison Service (FLS) last October 20.

FLS is a secondary prevention model aimed at subsequent fractures, known as fracture cascade, from at-risk patients, such as those afflicted with osteoporosis wherein a bone becomes porous and easily breaks. 

In FLS, a patient diagnosed with fracture is identified (fracture capture), monitored and provided easy access to treatment thereafter. The at-risk patient is also assessed for further fall risk and counseled on preventive education.

The FLS model has shown to be effective in other countries. The risk for patients in contracting subsequent fractures is up to five times higher for those facilities without FLS, while those with a model in place, the risk is reduced.

“The FLS is essential to prevent further complication from hip fractures caused by osteoporosis,” said Dr Tabu during the launch.

FLS requires multidisciplinary approach to fully care for an at-risk patient. An orthopedic surgeon coordinates with other medical specialists such as those in anesthesiology, rehabilitation, internal medicine, and family health medicine, among others, according to Dr Mark Anthony Sandoval, of the hospital's Section of Endocrinology.

The team also includes dieticians and nurses.

In general, FLS ups recovery chances, lowers secondary cases, and increases life expectancy.

Furthermore, using FLS will allow a local health institution to build a database of fracture. In the Philippines, there is said to be “no data.”

“It is projected that in 2050, there will be 6.2 million fractures worldwide; 70 percent will come from the Asia Pacific, [or] more than three million. Our neighbors are already preparing for this,” said Dr Tabu, adding “[but] in our country, we don’t have data. We have big problem catching patients with osteoporosis who suffered fractures.”

It is difficult to roughly estimate the number of fractures locally, and many tend to be under-reported, especially in provinces.

“We want to spearhead this [FLS implementation] at PGH,” he added.

In a year, the UP-PGH FLS implementation is expected to yield an initial data finding.

“[With this] we will soon have data. If there is no data, then there is no policy from the DOH,” noted Carmencita Padilla, UP-Manila Chancellor. “We hope that we will be able to use the data [that will be] generated by the FLS, [and if possible] be adapted in other institutions as well,” she concluded. MIMS

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