Fracture liaison service: optimizing care from a nurse practitioner's perspective

A bone fracture in the elderly is - contrary to popular belief - certainly not always the inevitable consequence of bad luck or clumsiness. The first fracture should sound the alarm, because it is known that at such a time the chance of another fracture increases considerably. In addition to the extra pain and disability, some people will become an invalid or even die earlier. Of the 120,000 annual bone fractures in the elderly in the Netherlands, at least 35% involve bone fractures due to bone decalcification, also called osteoporosis. It regularly begins with an 'innocent' fracture of the wrist and shortly thereafter a fracture of the hip or vertebrae. These are the most serious fractures. On top of additional distress, fractures among the elderly due to osteoporosis are expensive and contribute substantially to higher care costs. Fracture Liaison Services assess the risk of additional bone fractures in patients after a broken bone, provide preventive nutrition and exercise advice and start bone-saving medication. This thesis shows that the organisation of these multidisciplinary services is best put in the hands of nurse specialists. The nurse specialist seems to be the right person to shape secondary fracture prevention in the Netherlands.