Hope after hip fracture with new registry toolbox launch

More than one million hip fractures are sustained in the Asia–Pacific (APAC) region every year, leading to an alarming rate of death and disability.¹ One in four patients will die within a year of their hip fracture, and less than half of those who survive regain their previous level of function.^2–5

To address these devastating statistics, the Asia Pacific Fragility Fracture Alliance (APFFA), in collaboration with the Fragility Fracture Network (FFN), has developed an innovative Hip Fracture Registry Toolbox — a practical and informative resource that explains the fundamental need, and how to best advocate, for the establishment of a national hip fracture registry.

Reported to be a world first, the toolbox is tailored to clinicians, hospital administrators, healthcare systems and governments, covering topics such as stakeholder engagement and consolidation, building a case for change, planning and funding a registry, setting up a pilot registry, and navigating governance and ethics approval.

According to Consultant Ortho-Geriatrician Professor Jacqui Close — Clinical Director of the Falls, Balance and Injury Research Centre at Neuroscience Research Australia (NeuRA) and APFFA Hip Fracture Registry Working Group Co-Chair — widescale implementation of hip fracture registries worldwide can facilitate vast improvements in care for the millions of people who sustain a hip fracture each year.^6,7

“Hospitals can utilise hip fracture registries to benchmark their provision of care against best practice clinical standards for acute care, rehabilitation and secondary fracture prevention. Furthermore, hip fracture registries can transform patient-level data into information that both equips and empowers hospital teams to identify and develop solutions for key challenges within their respective institutions, and to strive for ongoing improvement in care,” Professor Close said.

By 2050, one in four people in APAC will be aged over 60. This portion of the population is expected to triple between 2010 and 2050, reaching close to 1.3 billion people.⁸ Within the same timeframe, between 4.5 to 6.3 million hip fractures are predicted to occur worldwide, half of which will occur in Asia.⁹

Dr Hannah Seymour — Consultant Geriatrician and Medical Director at Fiona Stanley Fremantle Hospitals Group and APFFA Hip Fracture Registry Working Group Co-Chair — said that, considering the exponential increase in the incidence and costs associated with hip fractures to date, and those anticipated globally, hip fracture registries serve as a vital tool underpinning quality improvement initiatives in the APAC region and globally.

“As of April 2021, 18 countries across Asia–Pacific, Europe, Latin America and North America had established a hip fracture registry, at different stages of maturation, participation and development. Notably, only three registries are currently operating in the Asia–Pacific,” Dr Seymour explained.

“The Hip Fracture Registry Toolbox explains how timely, reliable and constructive feedback to clinical teams, coupled with the engagement and participation of key stakeholders, improves the impact of hip fracture registries.

With adequate operational efficiency and funding, registries can improve health care, and are likely to prove significantly cost-effective.¹⁰ Registries can contribute to government initiatives designed to manage rapidly ageing populations, and can further help governments to promote the equitable provision of care.¹¹

According to Orthopaedic Surgeon and APFFA Co-Chair Dato’ Dr Joon-Kiong Lee, the release of the toolbox coincides with the launch of APFFA’s YouTube channel.

“The APFFA YouTube channel will house a series of educational videos featuring interviews with leading clinicians from the Asia–Pacific bone arena, reflecting on important considerations for each of the seven key steps involved in establishing a hip fracture registry.

“We trust our APFFA and FFN Toolbox, and supporting videos, will arm our colleagues throughout Asia–Pacific, and the rest of the world, with the necessary inspiration, knowledge and guidance on how to successfully establish a national hip fracture registry in their respective countries,” Dato’ Dr Lee said.

To download the Hip Fracture Registry Toolbox, visit www.apfracturealliance.org/HFR-toolbox/.

References

1. Cheung, C.-L., et al., An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study. Osteoporosis and sarcopenia, 2018. 4(1): p. 16-21.
2. National Osteoporosis Foundation, NOF's Clinician's Guide to Prevention and Treatment of Osteoporosis.
3. Australian Institute of Health and Welfare. Musculoskeletal fact sheet. Osteoporosis. [cited Jan, 2020]; Available from: https://www.aihw.gov.au/getmedia/61866386-568b-41fa-93e4-090ad201ab2b/phe187-osteoporosis-factsheet.pdf.aspx
4. Cosman, F., et al., Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2014. 25(10): p. 2359-2381.
5. Downey, C., M. Kelly, and J.F. Quinlan, Changing trends in the mortality rate at 1-year post hip fracture - a systematic review. World journal of orthopedics, 2019. 10(3): p. 166-175.
6. Currie, C., Hip fracture audit: Creating a 'critical mass of expertise and enthusiasm for hip fracture care'? Injury, 2018. 49(8): p. 1418-1423.
7. Wise, J., Hip fracture audit may have saved 1000 lives since 2007. BMJ : British Medical Journal, 2015. 351: p. h3854.
8. United Nation Population Fund (UNFPA) Asia & the Pacific. Ageing. [cited May]; Available from: https://asiapacific.unfpa.org/en/node/15208.
9. Cheung, C.L., et al., An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study. Osteoporos Sarcopenia, 2018. 4(1): p. 16-21.
10. Australian Commission on Safety and Quality in Health Care, Economic evaluation of clinical quality registries. 2016.
11. Australian Government, National Clinical Quality Registry and Virtual Registry Strategy - A National Strategy for Clinical Quality Registries and Virtual Registries 2020-2030. 2020.