Post-fracture care (PFC) programs, such as Fracture Liaison Services (FLS), systematically identify, diagnose, treat, and manage patients with osteoporosis. They are coordinator-based, secondary fracture prevention services implemented by healthcare systems established for the purpose of identifying and treating patients with osteoporosis.2,3
A post-fracture care program can help ensure care delivery across care sites while improving health outcomes and reducing system costs2,4
35% of subsequent fractures occurred within the first year following the prior fracture.1,* As such, post-fracture care programs can close critical gaps in osteoporosis care and implement services aimed at preventing subsequent fractures.
Identify patients at high risk for secondary fractures using guidelines for patient screening, diagnosing, and treatment4
Reduce fracture incidence with appropriate management and treatment, which can help reduce costs to the healthcare system2-4
Ensure care continuity across multiple care sites2,3
Align with certain key indicators to guide quality improvement4
*Total subsequent fractures were tallied over a 5-year period following the prior fracture. Of this total, 35% occurred within the first year.
Identify a champion who can develop, implement, and provide clinical leadership to a post-fracture care program5
Post Fracture Care can be supported by many departments:
“Anybody who has an interest can do this. The downside is everybody thinks someone else is going to do it, which is I think, in part, why these patients fall through the cracks.” – Andrea Singer, MD
Build your team: Secure commitment from stakeholders across the care continuum5,6
Interdisciplinary care team may include multiple roles (eg, clinical, care coordination, medication management) from various departments
Consider engaging primary care providers for patient referrals and long-term management
Clinical informaticists may be important to optimize electronic health record (EHR) systems to identify and manage patients.6
Engage with local administrators to seek funding and support2,5,6
Local administrators could include:
Align with stakeholders to effectively advocate and present a unified case.
Implement, grow, and sustain your PFC program
The first 3 elements of a successful program
Champions implement a pilot or a PFC protocol or care pathway to identify, investigate, and intervene to systematically improve care for post-fracture patients:
Identification: Patients are systematically identified for follow-up post fracture
Investigation: Fracture patients are systematically provided with an additional touchpoint to investigate osteoporosis needs
Intervention: Intervention is provided to reduce risk for appropriate osteoporosis patients post fracture
When these 3 priority elements are incorporated into a post-fracture care program, there is an improvement in osteoporosis screening and treatment rates.
Note: Refer to 7 Elements of a High-Functioning PFC for additional recommendations for effective PFC implementation.
EHR systems can be used to help identify, investigate, and intervene with appropriate patients. Explore available resources to see how these systems can help automate the identification of patients with osteoporosis-related fractures to help improve patient care.
IT, information technology; PFC, post-fracture care.
References: 1. Balasubramanian A, Zhang J, Chen L, et al. Risk of subsequent fracture after prior fracture among older women. Osteoporos Int. 2019;30:79-92. 2. Curtis JR, 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;11:365-368. 3. Capture the Fracture. What is a post fracture care coordination program (PFC)? Accessed July 19, 2025. https://www.capturethefracture.org/index.php/what-is-a-pfc. 4. Miller AN, Lake AF, Emory CL. Establishing a fracture liaison service: an orthopaedic approach. J Bone Joint Surg Am. 2015;97:675-681. 5. Bone Health & Osteoporosis Foundation. FLS stakeholder roles. Accessed July 19, 2025. https://www.bonesource.org/fls-stakeholder-roles. 6. Le HV, Van BW, Shazad H, et al. Fracture liaison service-a multidisciplinary approach to osteoporosis management. Osteoporos Int. 2024;35:1719-1727.
