Implementation of an integrated care programme to avoid fragility fractures of the hip in older adults in 18 Bavarian hospitals – study protocol for the cluster-randomised controlled fracture liaison service FLS-CARE

  1. Geiger, Isabel ORCID logo
  2. Kammerlander, Christian
  3. Höfer, Christine
  4. Volland, Ruth
  5. Trinemeier, Jörg
  6. Henschelchen, Martina
  7. Friess, Thomas
  8. Andrae, Ursula
  9. Stäudel, Christian
  10. Andress, Hans-Joachim
  11. Liese, Theresa
  12. Behnke, Maik
  13. Stojanovic, Milos
  14. Brunner, Ulrich
  15. Schreiber, Sabine
  16. Gradl, Georg
  17. Fürst, Benedikt
  18. Grote, Stefan
  19. Schmid, Constantin
  20. Grüninger, Sebastian
  21. Wicklein, Susanne
  22. Lewens, Tobias
  23. Gelse, Kolja
  24. Löffler, Thomas
  25. Bendiks, Martin
  26. Meffert, Rainer H.
  27. Schmitz, Benedikt
  28. Neuerburg, Carl
  29. Odenwald, Martin
  30. Thoma, Maximilian
  31. Schmitz, Paul
  32. Kretschmer, Rainer
  33. Schupfner, Rupert
  34. Pfeifer, Eva
  35. Solovyov, Igor
  36. Linder, Christian
  37. Stumpf, Ulla
  38. Werther, Jutta
  39. Fenwick, Annabel
  40. Zeckey, Christian
  41. Ditto, Joseph
  42. Böcker, Wolfgang
  43. Sundmacher, Leonie

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1000 Titel
  • Implementation of an integrated care programme to avoid fragility fractures of the hip in older adults in 18 Bavarian hospitals – study protocol for the cluster-randomised controlled fracture liaison service FLS-CARE
1000 Autor/in
  1. Geiger, Isabel |
  2. Kammerlander, Christian |
  3. Höfer, Christine |
  4. Volland, Ruth |
  5. Trinemeier, Jörg |
  6. Henschelchen, Martina |
  7. Friess, Thomas |
  8. Andrae, Ursula |
  9. Stäudel, Christian |
  10. Andress, Hans-Joachim |
  11. Liese, Theresa |
  12. Behnke, Maik |
  13. Stojanovic, Milos |
  14. Brunner, Ulrich |
  15. Schreiber, Sabine |
  16. Gradl, Georg |
  17. Fürst, Benedikt |
  18. Grote, Stefan |
  19. Schmid, Constantin |
  20. Grüninger, Sebastian |
  21. Wicklein, Susanne |
  22. Lewens, Tobias |
  23. Gelse, Kolja |
  24. Löffler, Thomas |
  25. Bendiks, Martin |
  26. Meffert, Rainer H. |
  27. Schmitz, Benedikt |
  28. Neuerburg, Carl |
  29. Odenwald, Martin |
  30. Thoma, Maximilian |
  31. Schmitz, Paul |
  32. Kretschmer, Rainer |
  33. Schupfner, Rupert |
  34. Pfeifer, Eva |
  35. Solovyov, Igor |
  36. Linder, Christian |
  37. Stumpf, Ulla |
  38. Werther, Jutta |
  39. Fenwick, Annabel |
  40. Zeckey, Christian |
  41. Ditto, Joseph |
  42. Böcker, Wolfgang |
  43. Sundmacher, Leonie |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-01-12
1000 Erschienen in
1000 Quellenangabe
  • 21(1):43
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s12877-020-01966-1 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801785/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!The economic and public health burden of fragility fractures of the hip in Germany is high. The likelihood of requiring long-term care and the risk of suffering from a secondary fracture increases substantially after sustaining an initial fracture. Neither appropriate confirmatory diagnostics of the suspected underlying osteoporosis nor therapy, which are well-recognised approaches to reduce the burden of fragility fractures, are routinely initiated in the German healthcare system. Therefore, the aim of the study FLS-CARE is to evaluate whether a coordinated care programme can close the prevention gap for patients suffering from a fragility hip fracture through the implementation of systematic diagnostics, a falls prevention programme and guideline-adherent interventions based on the Fracture Liaison Services model.!##!Methods!#!The study is set up as a non-blinded, cluster-randomised, controlled trial with unequal cluster sizes. Allocation to intervention group (FLS-CARE) and control group (usual care) follows an allocation ratio of 1:1 using trauma centres as the unit of allocation. Sample size calculations resulted in a total of 1216 patients (608 patients per group distributed over 9 clusters) needed for the analysis. After informed consent, all participants are assessed directly at discharge, after 3 months, 12 months and 24 months. The primary outcome measure of the study is the secondary fracture rate 24 months after initial hip fracture. Secondary outcomes include differences in the number of falls, mortality, quality-adjusted life years, activities of daily living and mobility.!##!Discussion!#!This study is the first to assess the effectiveness and cost-effectiveness/utility of FLS implementation in Germany. Findings of the process evaluation will also shed light on potential barriers to the implementation of FLS in the context of the German healthcare system. Challenges for the study include the successful integration of the outpatient sector as well as the future course of the coronavirus pandemic in 2020 and its influence on the intervention.!##!Trial registration!#!German Clinical Trial Register (DRKS) 00022237 , prospectively registered 2020-07-09.
1000 Sacherschließung
lokal Health services research
lokal Aged [MeSH]
lokal Secondary prevention
lokal Study Protocol
lokal Humans [MeSH]
lokal Hospitals [MeSH]
lokal Osteoporosis
lokal Osteoporotic Fractures/prevention
lokal Germany/epidemiology [MeSH]
lokal Randomized Controlled Trials as Topic [MeSH]
lokal Integrated care
lokal Activities of Daily Living [MeSH]
lokal Fragility fracture
lokal Osteoporotic Fractures/epidemiology [MeSH]
lokal Hip fracture
lokal Secondary Prevention [MeSH]
lokal Delivery of Health Care, Integrated [MeSH]
lokal Fracture liaison service
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0002-2303-2190|https://frl.publisso.de/adhoc/uri/S2FtbWVybGFuZGVyLCBDaHJpc3RpYW4=|https://frl.publisso.de/adhoc/uri/SMO2ZmVyLCBDaHJpc3RpbmU=|https://frl.publisso.de/adhoc/uri/Vm9sbGFuZCwgUnV0aA==|https://frl.publisso.de/adhoc/uri/VHJpbmVtZWllciwgSsO2cmc=|https://frl.publisso.de/adhoc/uri/SGVuc2NoZWxjaGVuLCBNYXJ0aW5h|https://frl.publisso.de/adhoc/uri/RnJpZXNzLCBUaG9tYXM=|https://frl.publisso.de/adhoc/uri/QW5kcmFlLCBVcnN1bGE=|https://frl.publisso.de/adhoc/uri/U3TDpHVkZWwsIENocmlzdGlhbg==|https://frl.publisso.de/adhoc/uri/QW5kcmVzcywgSGFucy1Kb2FjaGlt|https://frl.publisso.de/adhoc/uri/TGllc2UsIFRoZXJlc2E=|https://frl.publisso.de/adhoc/uri/QmVobmtlLCBNYWlr|https://frl.publisso.de/adhoc/uri/U3RvamFub3ZpYywgTWlsb3M=|https://frl.publisso.de/adhoc/uri/QnJ1bm5lciwgVWxyaWNo|https://frl.publisso.de/adhoc/uri/U2NocmVpYmVyLCBTYWJpbmU=|https://frl.publisso.de/adhoc/uri/R3JhZGwsIEdlb3Jn|https://frl.publisso.de/adhoc/uri/RsO8cnN0LCBCZW5lZGlrdA==|https://frl.publisso.de/adhoc/uri/R3JvdGUsIFN0ZWZhbg==|https://frl.publisso.de/adhoc/uri/U2NobWlkLCBDb25zdGFudGlu|https://frl.publisso.de/adhoc/uri/R3LDvG5pbmdlciwgU2ViYXN0aWFu|https://frl.publisso.de/adhoc/uri/V2lja2xlaW4sIFN1c2FubmU=|https://frl.publisso.de/adhoc/uri/TGV3ZW5zLCBUb2JpYXM=|https://frl.publisso.de/adhoc/uri/R2Vsc2UsIEtvbGph|https://frl.publisso.de/adhoc/uri/TMO2ZmZsZXIsIFRob21hcw==|https://frl.publisso.de/adhoc/uri/QmVuZGlrcywgTWFydGlu|https://frl.publisso.de/adhoc/uri/TWVmZmVydCwgUmFpbmVyIEgu|https://frl.publisso.de/adhoc/uri/U2NobWl0eiwgQmVuZWRpa3Q=|https://frl.publisso.de/adhoc/uri/TmV1ZXJidXJnLCBDYXJs|https://frl.publisso.de/adhoc/uri/T2RlbndhbGQsIE1hcnRpbg==|https://frl.publisso.de/adhoc/uri/VGhvbWEsIE1heGltaWxpYW4=|https://frl.publisso.de/adhoc/uri/U2NobWl0eiwgUGF1bA==|https://frl.publisso.de/adhoc/uri/S3JldHNjaG1lciwgUmFpbmVy|https://frl.publisso.de/adhoc/uri/U2NodXBmbmVyLCBSdXBlcnQ=|https://frl.publisso.de/adhoc/uri/UGZlaWZlciwgRXZh|https://frl.publisso.de/adhoc/uri/U29sb3Z5b3YsIElnb3I=|https://frl.publisso.de/adhoc/uri/TGluZGVyLCBDaHJpc3RpYW4=|https://frl.publisso.de/adhoc/uri/U3R1bXBmLCBVbGxh|https://frl.publisso.de/adhoc/uri/V2VydGhlciwgSnV0dGE=|https://frl.publisso.de/adhoc/uri/RmVud2ljaywgQW5uYWJlbA==|https://frl.publisso.de/adhoc/uri/WmVja2V5LCBDaHJpc3RpYW4=|https://frl.publisso.de/adhoc/uri/RGl0dG8sIEpvc2VwaA==|https://frl.publisso.de/adhoc/uri/QsO2Y2tlciwgV29sZmdhbmc=|https://frl.publisso.de/adhoc/uri/U3VuZG1hY2hlciwgTGVvbmll
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