It’s not uncommon for an elderly person to breaking a bone from a single slip. Fragility fracture is a good predictor of osteoporosis, a disease of decline in bone mass and density commonly found among elderly people. Those who have already experienced a fracture are at significant risk from a second one, especially within the first year (or imminent fractures). Not only do second-time fractures cost the patient a fortune, but it may also cost a life and put constant pressure on the public healthcare system. Resources should be allocated for identification and prevention during this golden period. There is currently a shortage of prevention services and dedicated clinics for fragility fracture management in Hong Kong. Other difficulties include low screening and anti-osteoporosis medication prescription rates, limited follow-up attendance, and low compliance of oral drugs.

“The necessary technologies are already here, it’s just a matter of innovating a care model to deploy them.”The team has established a dedicated clinic at the Prince of Wales Hospital with proactive recruitment of patients via information pamphlets and talks. Patients will be screened via Dual Energy X-ray Absorptiometry (DXA) scans and closely followed up with advice. Oral drugs are replaced by half-yearly injection to improve compliance of therapy, on top of low-magnitude high-frequency vibration (LMHFV) therapy available at clinics and community centres. This systematic liaison service is setting a structured standard of care for secondary fracture prevention among patients.

The team revolutionises fragility fracture patient management by focusing on imminent fracture prevention, providing early diagnosis and patient-specific treatment. By reducing subsequent falls and fractures, this service model relieves not only suffering for the patients and their family, but also pressure for our healthcare system in the long run. The team dreams big: they wish to see the developed care protocol widely adapted in the territory’s healthcare system, for instance, in future community health centres.which embraces multiple learning styles and preferences.

– 120 vertebral fragility fracture patients– 120 patient caregivers– 160 community elderly

2019

Active Ageing, Healthcare, Well-being