Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Internal Medicine


Laura Witte, PhD, PA-C


Fracture Liaison Services (FLS), commonly led by physician assistants (PA) or nurse practitioners (NP), are designed to identify osteoporosis patients at first fracture to ensure their bone-health needs are fully evaluated and addressed. Osteoporosis is a systemic and progressive disease, common in post-menopausal women, characterized by bone-density loss resulting in increased fracture risk. It is largely undiagnosed and undertreated and those with a first fracture are at substantially increased risk for a second. This paper describes four FLS models that vary in intensity of interaction with patients and reviews evidence describing their effectiveness. This review suggests FLS patients are more likely to be properly diagnosed, started, and maintained on appropriate therapy, and effectively managed over time. The data on whether this will reduce re-fracture rates and/or reduce mortality are less robust, but the totality of evidence suggests these PA and/or NP led services are beneficial for their patients.


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