nach oben

Erschienen in:

19.02.2018 | Review

Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature

verfasst von: C.-H. Wu, I.-J. Kao, W.-C. Hung, S.-C. Lin, H.-C. Liu, M.-H. Hsieh, S. Bagga, M. Achra, T.-T. Cheng, R.-S. Yang

Erschienen in: Osteoporosis International | Ausgabe 6/2018

Einloggen, um Zugang zu erhalten

Abstract

Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016. Grey literature (e.g., Google scholar, conference abstracts/posters) were also hand searched through February 2017. Two independent reviewers screened titles and abstracts and conducted full-text review on qualified articles. All disagreements were resolved by discussion between reviewers to reach consensus or by a third reviewer. In total, 23 qualified studies that evaluated the economic aspects of FLS were included: 16 cost-effectiveness studies, 2 cost-benefit analyses, and 5 studies of cost savings. Patient populations varied (prior fragility fracture, non-vertebral fracture, hip fracture, wrist fracture), and FLS strategies ranged from mail-based interventions to comprehensive nurse/physician-coordinated programs. Cost-effectiveness studies were conducted in Canada, Australia, USA, UK, Japan, Taiwan, and Sweden. FLS was cost-effective in comparisons with usual care or no treatment, regardless of the program intensity or the country in which the FLS was implemented (cost/QALY from $3023–$28,800 US dollars (USD) in Japan to $14,513–$112,877 USD in USA. Several studies documented cost savings. FLS, implemented in different ways and countries, are reported to be cost-effective or even cost-saving. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards.

Nur mit Berechtigung zugänglich

Bouxsein ML, Karasik D (2006) Bone geometry and skeletal fragility. Curr Osteoporos Rep 4(2):49–56. https://doi.org/10.1007/s11914-006-0002-9 CrossRefPubMed

Recker R, Lappe J, Davies KM, Heaney R (2004) Bone remodeling increases substantially in the years after menopause and remains increased in older osteoporosis patients. J Bone Miner Res 19(10):1628–1633. https://doi.org/10.1359/JBMR.040710 CrossRefPubMed

Seeman E (2008) Bone quality: the material and structural basis of bone strength. J Bone Miner Metab 26(1):1–8. https://doi.org/10.1007/s00774-007-0793-5 CrossRefPubMed

Tella SH, Gallagher JC (2014) Biological agents in management of osteoporosis. Eur J Clin Pharmacol 70(11):1291–1301. https://doi.org/10.1007/s00228-014-1735-5 CrossRefPubMed

Melton LJ 3rd, Atkinson EJ, O'Connor MK, O'Fallon WM, Riggs BL (1998) Bone density and fracture risk in men. J Bone Miner Res 13(12):1915–1923. https://doi.org/10.1359/jbmr.1998.13.12.1915 CrossRefPubMed

Melton LJ 3rd, Chrischilles EA, Cooper C, Lane AW, Riggs BL (1992) Perspective. How many women have osteoporosis? J Bone Miner Res 7(9):1005–1010. https://doi.org/10.1002/jbmr.5650070902 CrossRefPubMed

Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22(3):465–475. https://doi.org/10.1359/jbmr.061113 CrossRefPubMed

Kanis JA, Borgstrom F, Compston J, Dreinhofer K, Nolte E, Jonsson L, Lems WF, McCloskey EV, Rizzoli R, Stenmark J (2013) SCOPE: a scorecard for osteoporosis in Europe. Arch Osteoporos 8(1-2):144. https://doi.org/10.1007/s11657-013-0144-1 CrossRefPubMedPubMedCentral

Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301(5):513–521. https://doi.org/10.1001/jama.2009.50 CrossRefPubMed

10.

Ioannidis G, Papaioannou A, Hopman WM et al (2009) Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study. CMAJ 181:265–271CrossRefPubMedPubMedCentral

11.

Tajeu GS, Delzell E, Smith W, Arora T, Curtis JR, Saag KG, Morrisey MA, Yun H, Kilgore ML (2014) Death, debility, and destitution following hip fracture. J Gerontol A Biol Sci Med Sci 69:346–353CrossRefPubMed

12.

Delmas PD, Genant HK, Crans GG, Stock JL, Wong M, Siris E, Adachi JD (2003) Severity of prevalent vertebral fractures and the risk of subsequent vertebral and nonvertebral fractures: results from the MORE trial. Bone 33(4):522–532. https://doi.org/10.1016/S8756-3282(03)00241-2 CrossRefPubMed

13.

FitzGerald G, Boonen S, Compston JE, Pfeilschifter J, LaCroix AZ, HosmerDW J, Hooven FH, Gehlbach SH, Investigators G (2012) Differing risk profiles for individual fracture sites: evidence from the Global Longitudinal Study of Osteoporosis in Women (GLOW). J Bone Miner Res 27(9):1907–1915. https://doi.org/10.1002/jbmr.1652 CrossRefPubMed

14.

Giangregorio LM, Leslie WD, Manitoba Bone DensityProgram (2010) Time since prior fracture is a risk modifier for 10-year osteoporotic fractures. J Bone Miner Res 25(6):1400–1405. https://doi.org/10.1002/jbmr.35 CrossRefPubMed

15.

Haentjens P, Autier P, Collins J, Velkeniers B, Vanderschueren D, Boonen S (2003) Colles fracture, spine fracture, and subsequent risk of hip fracture in men and women. A meta-analysis J Bone Joint Surg Am 85-A(10):1936–1943CrossRefPubMed

16.

Johnell O, Kanis JA, Oden A, Sernbo I, Redlund-Johnell I, Petterson C, De Laet C, Jonsson B (2004) Fracture risk following an osteoporotic fracture. Osteoporos Int 15(3):175–179. https://doi.org/10.1007/s00198-003-1514-0 CrossRefPubMed

17.

Kanis JA, Johnell O, De Laet C et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382CrossRefPubMed

18.

Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15(4):721–739. https://doi.org/10.1359/jbmr.2000.15.4.721 CrossRefPubMed

19.

Roux C, Fechtenbaum J, Kolta S, Briot K, Girard M (2007) Mild prevalent and incident vertebral fractures are risk factors for new fractures. Osteoporos Int 18:1617–1624CrossRefPubMed

20.

van Staa TP, Leufkens HG, Cooper C (2002) Does a fracture at one site predict later fractures at other sites? A British cohort study. Osteoporos Int 13(8):624–629. https://doi.org/10.1007/s001980200084 CrossRefPubMed

21.

Wustrack R, Seeman E, Bucci-Rechtweg C, Burch S, Palermo L, Black DM (2012) Predictors of new and severe vertebral fractures: results from the HORIZON Pivotal Fracture Trial. Osteoporos Int 23(1):53–58. https://doi.org/10.1007/s00198-011-1664-4 CrossRefPubMed

22.

Kanis JA, Adachi JD, Cooper C et al (2013) Standardising the descriptive epidemiology of osteoporosis: recommendations from the Epidemiology and Quality of Life Working Group of IOF. Osteoporos Int 24(11):2763–2764. https://doi.org/10.1007/s00198-013-2413-7 CrossRefPubMedPubMedCentral

23.

International Osteoprosis Foundation (2012) Capture the Fracture: a global campaign to break the fragility fracture cycle

24.

Lindsay R, Burge RT, Strauss DM (2005) One year outcomes and costs following a vertebral fracture. Osteoporos Int 16(1):78–85. https://doi.org/10.1007/s00198-004-1646-x CrossRefPubMed

25.

Lindsay R, Silverman SL, Cooper C et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285(3):320–323. https://doi.org/10.1001/jama.285.3.320 CrossRefPubMed

26.

Colón-Emeric C, Kuchibhatla M, Pieper C, Hawkes W, Fredman L, Magaziner J, Zimmerman S, Lyles KW (2003) The contribution of hip fracture to risk of subsequent fractures: data from two longitudinal studies. Osteoporos Int 14(11):879–883. https://doi.org/10.1007/s00198-003-1460-x CrossRefPubMed

27.

Lyles KW, Schenck AP, Colon-Emeric CS (2008) Hip and other osteoporotic fractures increase the risk of subsequent fractures in nursing home residents. Osteoporos Int 19(8):1225–1233. https://doi.org/10.1007/s00198-008-0569-3 CrossRefPubMedPubMedCentral

28.

Balasubramanian A, Tosi LL, Lane JM, Dirschl DR, Ho PR, O'Malley CD (2014) Declining rates of osteoporosis management following fragility fractures in the U.S., 2000 through 2009. J Bone Joint Surg Am 96(7):e52. https://doi.org/10.2106/JBJS.L.01781 CrossRefPubMed

29.

Fraser LA, Ioannidis G, Adachi JD et al (2011) Fragility fractures and the osteoporosis care gap in women: the Canadian Multicentre Osteoporosis Study. Osteoporos Int 22:789–796CrossRefPubMed

30.

Hagino H, Sawaguchi T, Endo N, Ito Y, Nakano T, Watanabe Y (2012) The risk of a second hip fracture in patients after their first hip fracture. Calcif Tissue Int 90(1):14–21. https://doi.org/10.1007/s00223-011-9545-6 CrossRefPubMed

31.

Yusuf AA, Matlon TJ, Grauer A, Barron R, Chandler D, Peng Y (2016) Utilization of osteoporosis medication after a fragility fracture among elderly Medicare beneficiaries. Arch Osteoporos 11(1):31. https://doi.org/10.1007/s11657-016-0285-0 CrossRefPubMed

32.

Siris ES, Selby PL, Saag KG, Borgstrom F, Herings RM, Silverman SL (2009) Impact of osteoporosis treatment adherence on fracture rates in North America and Europe. Am J Med 122(2):S3–13. https://doi.org/10.1016/j.amjmed.2008.12.002 CrossRefPubMed

33.

Akesson K, Marsh D, Mitchell PJ, AR ML, Stenmark J, Pierroz DD, Kyer C, Cooper C, Group IOFFW (2013) Capture the fracture: a best practice framework and global campaign to break the fragility fracture cycle. Osteoporos Int 24:2135–2152CrossRefPubMedPubMedCentral

34.

International Osteoporosis Foundation. Capture the Fracture Best Practice Framework. www.capture-the-fracture.org/node/20 Accessed 30 August 2017

35.

International Osteoporosis Foundation (2017) New milestone with 212 FLS mapped. http://www.capture-the-fracture.org/new-milestone-212-fls-mapped Accessed 10 June 2017

36.

Walters S, Khan T, Ong T, Sahota O (2017) Fracture liaison services: improving outcomes for patients with osteoporosis. Clin Interv Aging 12:117–127. https://doi.org/10.2147/CIA.S85551 CrossRefPubMedPubMedCentral

37.

Wu CHT, Tu S, Chang YF, Chan DC, Chien JT, Lin CH, Singh S, Dasari M, Chen JF, Tsai KS (2017) Fracture liaison services improve outcomes of patients with osteoporosis-related fractures: a systematic literature review and meta-analysis. Osteoporosis and Sarcopenia 3(3):S51–S52. https://doi.org/10.1016/j.afos.2017.08.096 CrossRef

38.

The Cochrane Collaboration (2011) Cochrane handbook for systematic reviews of interventions. http://handbook-5-1.cochrane.org/chapter_15/15_5_2_critical_appraisal_of_methodological_quality.htm. Accessed 15 January 2018

39.

An Introduction to the Principles of Critical Appraisal of Health Economic Evaluation Studies. ttps://www.nlm.nih.gov/nichsr/edu/healthecon/drummond_list.html. Accessed 02 May 2017

40.

Majumdar SR, Johnson JA, Lier DA et al (2007) Persistence, reproducibility, and cost-effectiveness of an intervention to improve the quality of osteoporosis care after a fracture of the wrist: results of a controlled trial. Osteoporos Int 18(3):261–270. https://doi.org/10.1007/s00198-006-0248-1 CrossRefPubMed

41.

Majumdar SR, Lier DA, Beaupre LA, Hanley DA, Maksymowych WP, Juby AG, Bell NR, Morrish DW (2009) Osteoporosis case manager for patients with hip fractures: results of a cost-effectiveness analysis conducted alongside a randomized trial. Arch Intern Med 169(1):25–31. https://doi.org/10.1001/archinte.169.1.25 CrossRefPubMed

42.

Majumdar SR, Lier DA, Leslie WD (2013) Cost-effectiveness of two inexpensive postfracture osteoporosis interventions: results of a randomized trial. J Clin Endocrinol Metab 98(5):1991–2000. https://doi.org/10.1210/jc.2013-1034 CrossRefPubMed

43.

Majumdar SR, Lier DA, Rowe BH, Russell AS, McAlister FA, Maksymowych WP, Hanley DA, Morrish DW, Johnson JA (2011) Cost-effectiveness of a multifaceted intervention to improve quality of osteoporosis care after wrist fracture. Osteoporos Int 22(6):1799–1808. https://doi.org/10.1007/s00198-010-1412-1 CrossRefPubMed

44.

McLellan AR, Wolowacz SE, Zimovetz EA, Beard SM, Lock S, McCrink L, Adekunle F, Roberts D (2011) Fracture liaison services for the evaluation and management of patients with osteoporotic fracture: a cost-effectiveness evaluation based on data collected over 8 years of service provision. Osteoporos Int 22(7):2083–2098. https://doi.org/10.1007/s00198-011-1534-0 CrossRefPubMed

45.

Solomon DH, Patrick AR, Schousboe J, Losina E (2014) The potential economic benefits of improved postfracture care: a cost-effectiveness analysis of a fracture liaison service in the US health-care system. J Bone Miner Res 29(7):1667–1674. https://doi.org/10.1002/jbmr.2180 CrossRefPubMedPubMedCentral

46.

Leal J, Gray AM, Hawley S, Prieto-Alhambra D, Delmestri A, Arden NK, Cooper C, Javaid MK, Judge A, the RSG (2017) Cost-effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: a population-based study. J Bone Miner Res 32(2):203–211. https://doi.org/10.1002/jbmr.2995 CrossRefPubMed

47.

Cooper MS, Palmer AJ, Seibel MJ (2012) Cost-effectiveness of the Concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study. Osteoporos Int 23(1):97–107. https://doi.org/10.1007/s00198-011-1802-z CrossRefPubMed

48.

Yong JH, Masucci L, Hoch JS, Sujic R, Beaton D (2016) Cost-effectiveness of a fracture liaison service—a real-world evaluation after 6 years of service provision. Osteoporos Int 27:231–240CrossRefPubMed

49.

Yates CJ, Chauchard MA, Liew D, Bucknill A, Wark JD (2015) Bridging the osteoporosis treatment gap: performance and cost-effectiveness of a fracture liaison service. J Clin Densitom 18(2):150–156. https://doi.org/10.1016/j.jocd.2015.01.003 CrossRefPubMed

50.

Swart E, Vasudeva E, Makhni EC, Macaulay W, Bozic KJ (2016) Dedicated perioperative hip fracture comanagement programs are cost-effective in high-volume centers: an economic analysis. Clin Orthop Relat Res 474:222–233CrossRefPubMed

51.

Inderjeeth CAR, Raymond W, Geelhoed E, Briggs A, Briffa K, Oldham D, McQuade J, Mountain D (2016) Fracture liaison service reduces re-fracture rate, cost-effective and cost saving in Western Australia. Annals of Rheumatic Diseases 75:360–361

52.

Taylor C, Jan S (2017) Economic evaluations of medicines. Aust Prescr 40(2):76–78. https://doi.org/10.18773/austprescr.2017.014 CrossRefPubMedPubMedCentral

53.

Griffiths E, Vadlamudi N.K. (2016) CADTH’s $50,000 cost-effectiveness threshold: fact or fiction? International Society of Pharmacoeconomics and Outcomes Research

54.

Neumann PJ, Cohen JT, Weinstein MC (2014) Updating cost-effectiveness—the curious resilience of the $50,000-per-QALY threshold. N Engl J Med 371(9):796–797. https://doi.org/10.1056/NEJMp1405158 CrossRefPubMed

55.

DillionA (2015) Carrying NICE over the threshold. https://wwwniceorguk/news/blog/carrying-nice-over-the-threshold Accessed1 September 2017

56.

Jonsson E, Borgström F, Strom O (2016) Cost effectiveness evaluation of fracture liaison services for the management of osteoporosis in Sweden. Value Health 19(7):A612. https://doi.org/10.1016/j.jval.2016.09.1529 CrossRef

57.

Moriwaki K, Noto S (2017) Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan. Osteoporos Int 28(2):621–632. https://doi.org/10.1007/s00198-016-3777-2 CrossRefPubMed

58.

Department of Health UK (2009) Fracture Prevention Services: an economic evaluation

59.

SunmboyeKS, P. (2014) A fracture-liaison service at “zero cost”? A university teaching hospital experience. 73:766

60.

Sander B, Elliot-Gibson V, Beaton DE, Bogoch ER, Maetzel A (2008) A coordinator program in post-fracture osteoporosis management improves outcomes and saves costs. J Bone Joint Surg Am 90(6):1197–1205. https://doi.org/10.2106/JBJS.G.00980 CrossRefPubMed

61.

Irwin AN, Billups SJ, Heilmann RM (2015) Labor costs and economic impact of a primary care clinical pharmacy service on postfracture care in postmenopausal women. Pharmacotherapy 35(3):243–250. https://doi.org/10.1002/phar.1554 CrossRefPubMed

62.

Wong CC, McGirt MJ (2013) Vertebral compression fractures: a review of current management and multimodal therapy. J Multidiscip Healthc 6:205–214. https://doi.org/10.2147/JMDH.S31659 PubMedPubMedCentralCrossRef

63.

Sale JE, Beaton D, Posen J, Elliot-Gibson V, Bogoch E (2011) Systematic review on interventions to improve osteoporosis investigation and treatment in fragility fracture patients. Osteoporos Int 22:2067–2082CrossRefPubMed

64.

Ganda K, Puech M, Chen JS, Speerin R, Bleasel J, Center JR, Eisman JA, March L, Seibel MJ (2013) Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int 24(2):393–406. https://doi.org/10.1007/s00198-012-2090-y CrossRefPubMed

65.

Harvey NC, McCloskey EV, Mitchell PJ, Dawson-Hughes B, Pierroz DD, Reginster JY, Rizzoli R, Cooper C, Kanis JA (2017) Mind the (treatment) gap: a global perspective on current and future strategies for prevention of fragility fractures. Osteoporos Int 28(5):1507–1529. https://doi.org/10.1007/s00198-016-3894-y CrossRefPubMedPubMedCentral

Titel: Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature
verfasst von: C.-H. Wu
I.-J. Kao
W.-C. Hung
S.-C. Lin
H.-C. Liu
M.-H. Hsieh
S. Bagga
M. Achra
T.-T. Cheng
R.-S. Yang
Publikationsdatum: 19.02.2018
Verlag: Springer London
Erschienen in: Osteoporosis International / Ausgabe 6/2018
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-018-4411-2

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2018

Novel compound heterozygous mutations in SERPINH1 cause rare autosomal recessive osteogenesis imperfecta type X

Opportunistic screening for bone disease using abdominal CT scans obtained for other reasons in newly diagnosed IBD patients

The role of previous falls in major osteoporotic fracture prediction in conjunction with FRAX in older Chinese men and women: the Mr. OS and Ms. OS cohort study in Hong Kong

Depression and risk of fracture and bone loss: an updated meta-analysis of prospective studies

Low peak jump power is associated with elevated odds of dysmobility syndrome in community-dwelling elderly individuals: the Korean Urban Rural Elderly (KURE) study