VOLUME 6 - NUMBER 2 - 2026
The fracture liaison service in Italy: best practices
for secondary fracture prevention
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Barbara Rossi, Davide Di Fusco, Claudia Marchetta, Matteo Marconi, Serena Lavorgna, Gabriella Facchinetti,
Daniela D’Angelo, Marco Bressi, Gessica Cherubini, Jacopo Giammatteo, Bruno Velia
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Editorial, 58-63
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Full text PDF
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Purpose: Fragility fractures represent a major public health challenge due to their impact on mortality, disability, quality of life, and healthcare costs. This study aims to define clinical and organizational best practices for implementing the fracture liaison service (FLS) model in Italy, integrating International Osteoporosis Foundation (IOF) standards within the organizational framework of the Italian National Health Service. Methods: An evidence-informed narrative approach was developed integrating international literature on the FLS model, the IOF “Capture the Fracture” Best Practice Framework, and methodological principles of the Italian National Guidelines System. Organizational experiences from Italian regional initiatives and pilot programs were analyzed to identify operational components and transferable best practices. Evidence from clinical guidelines and real-world studies reporting reductions in refracture risk associated with implementation of the FLS model was also reviewed. Results: The proposed framework identifies key operational domains for FLS implementation: systematic case finding of fragility fractures, standardized osteoporosis and fall risk assessment, coordinated multidisciplinary management, timely initiation of pharmacologic therapy, and structured long-term follow-up. Evidence from real-world studies indicates that FLS programs increase rates of osteoporosis diagnosis and treatment and reduce the risk of subsequent fractures. Additional components include patient education, shared decision-making, integration of patient-reported outcomes, and structured collaboration between hospital services, primary care, and community rehabilitation networks. Conclusions: The integration of international FLS standards with national organizational best practices provides a practical framework to support the development and scaling of coordinated post-fracture care pathways in Italy, potentially improving secondary fracture prevention and continuity of care.
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KEY WORDS: Fragility fracture, osteoporosis, fracture liaison service, integrated care pathway.
