After an osteoporosis-related fracture, postmenopausal women are 5 times more likely to suffer another fracture within the first year, and the risk remains elevated over time.4,* Additionally, subsequent fractures lead to increased medical costs compared to an initial fracture.5,† A PFC program can help ensure care delivery across care sites while improving health outcomes and reducing system costs.1,2
A PFC program such as an FLS can also help achieve recommended standards of care for fragility fractures and align with certain key performance indicators to guide quality improvement.1,2,6
Osteoporosis evaluation 
Intervention for osteoporosis 
Secondary fracture prevention Helpful resources including tips and considerations for starting a PFC program at your institution
A PFC program such as a fracture liaison service (FLS), which assists in identifying and managing patients after a fracture, can help deliver appropriate post-fracture assessment and treatment2
*Data represent a population-based study of 4,140 postmenopausal women aged 50-80 years.
†Data based on a retrospective claim-based study, which assessed 1-year medical costs associated with second fracture(s) for patients over 50 years old with an initial closed hip, clinical vertebral, or nonhip nonvertebral fracture using 2002-2008 MarketScan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases.
Various Stakeholders May Be Involved in PFC Program7
PFC Champion
Specialties
Orthopedics
Geriatrics
Endocrinology
Rheumatology
Nephrology
Gynecology
Radiology
Family practitioners
Hospitalists
Internal medicine
Coordinator, Usually APPs (RN, PA, NP)
Additional care-team stakeholders
Discharge planners
Physical therapists
Care managers
Supporting Roles
Hospital administration and management
Hospital utilization managers
Care management leadership
Finance
Research departments
Quality improvement
professionals
Pharmacists
IT department
APP=advanced practice provider; NP=nurse practitioner; PA=physician associate; RN=registered nurse.
APP=advanced practice provider; NP=nurse practitioner; PA=physician associate; RN=registered nurse.
References: 1. Curtis JC, Silverman SL. Commentary: The five Ws of a fracture liaison service: why, who, what, where and how? In osteoporosis, we reap what we sow. Curr Osteoporos Rep. 2013;11. doi:10.1007/s11914-013-0177-9. 2. Capture the Fracture. What is a post fracture care coordination program (PFC)? Accessed February 15, 2022. https:// www.capturethefracture.org/what-is-a-pfc. 3. Miller AN, Lake AF, Emory CL. Establishing a fracture liaison service: an orthopaedic approach. J Bone Joint Surg Am. 2015;97:675-681. 4. van Geel TACM, van Helden S, Geusens PP, Winkens B, Dinant G-J. Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis. 2009;68:99-102. 5. Song X, Shi N, Badamgarav E, et al. Cost burden of second fracture in the US health system. Bone. 2011;48:828-836. 6. Camacho PM, Petak S, Binkley N, et al. American Association of Clinical Endocrinologists/American College of Endocrinology Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis-2020 Update. Endocr Pract. 2020;26(suppl 1):1-46. 7. National Osteoporosis Foundation website. FLS stakeholder roles. Accessed February 15, 2022. https://www.bonesource.org/fls-stakeholderroles. 8. Akesson K, Marsh D, Mitchell PJ. Capture the Fracture: a Best Practice Framework and global campaign to break the fragility fracture cycle. Osteoporos Int. 2013;24:2135-2152.
