[Post-Fracture Care in the Czech Republic: Adherence to Guidelines and Attitudes Toward Fracture Liaison Services].

Abstract

Purpose of the study: Untreated osteoporosis often leads to subsequent fractures associated with high morbidity and mortality. In the Czech Republic, approximately 15,000 patients are hospitalized annually with femoral neck fractures, with up to 25% mortality within the first year after a hip fracture. Establishing a coordinated post-fracture care program, such as Fracture Liaison Services (FLS), may substantially reduce this burden. In the FLS model, the role of the coordinator is pivotal. This study aimed to assess baseline adherence to national postfracture care guidelines and to evaluate nurses' attitudes toward the FLS program and the role of FLS coordinators in the Czech Republic.

Material and methods: Between May 25 and July 14, 2023, an anonymous electronic questionnaire was distributed to members of the Czech Association of Nurses working in surgical, orthopedic, and trauma departments. The survey assessed adherence to guideline-recommended discharge procedures and attitudes toward FLS implementation and coordinator certification.

Results: Adherence to national guidelines was poor across all evaluated domains of post-fracture care. Only a minority of respondents reported consistent patient education, scheduling of follow-up visits, referral for DXA examination, or prescription of vitamin D and calcium supplements. Nevertheless, 76% of participants believed that implementing an FLS program would improve the quality and effectiveness of post-fracture care, and 61% expressed interest in specialized training to become certified FLS coordinators.

Conclusions: Despite substantial gaps in current adherence to post-fracture care guidelines, nurses demonstrated strong support for the FLS model and recognized the importance of the coordinator role. These baseline findings indicate that successful implementation of FLS programs in the Czech Republic will require both system-level coordination and motivated, trained nurse coordinators.