porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo12952porozendo-12952Research ArticleНАУЧНЫЕ ОБЗОРЫREVIEWSДлительное наблюдение пациентов в службах профилактики повторных переломов: проблемы и пути их решения (обзор литературы и собственные данные)Long-term follow-up of patients in fracture liaison services: problems and solutions (literature review and own data)https://orcid.org/0000-0002-7856-1567БеловаК. Ю.BelovaK. Yu.

Белова Ксения Юрьевна, доктор медицинских наук, доцент кафедры терапии имени профессора Е.Н. Дормидонтова  

150000, Ярославль, ул. Революционная, д. 5 

eLibrary SPIN: 4372-8670

Ksenia Y. Belova, MD, PhD

5, Revolutsionnaya street, 15000 Yaroslavl

eLibrary SPIN: 4372-8670

ksbelova@mail.ruhttps://orcid.org/0000-0001-7167-2187ЕршоваО. Б.ErshovaO. B.

Ершова Ольга Борисовна, доктор медицинских наук, профессор

Ярославль

Researcher ID: I-9576-2017;

Scopus Author ID: 16734008200;

Author ID: 319822;

eLibrary SPIN: 8238-8201

Olga B. Ershova, MD, PhD, Professo

Yaroslavl

Researcher ID: I-9576-2017;

Scopus Author ID: 16734008200;

Author ID: 319822;

eLibrary SPIN: 8238-8201

yarosteoporosis@list.ruhttps://orcid.org/0000-0003-2392-6554ГорджеладзеХ. Г.GordzheladzeKh. G.

Горджеладзе Хатиа Геннадиевна,  врач-ревматолог 

Ярославль

Khatia G. Gordzheladze

Yaroslavl

khatia911@gmail.comФГБОУ ВО «Ярославский государственный медицинский университет» МЗ РФ; ГАУЗ ЯО «Клиническая больница скорой медицинской помощи имени Н.В. Соловьева»РоссияYaroslavl State Medical University; Yaroslavl Regional Emergency Care Hospital n.a. N.V. SolovyevRussian FederationГАУЗ ЯО «Клиническая больница скорой медицинской помощи имени Н.В. Соловьева»РоссияYaroslavl Regional Emergency Care Hospital n.a. N.V. SolovyevRussian Federation2022130120232541120Copyright © Белова К.Ю., Ершова О.Б., Горджеладзе Х.Г., 20232023Белова К.Ю., Ершова О.Б., Горджеладзе Х.Г.Belova K.Y., Ershova O.B., Gordzheladze K.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/12952

Для снижения частоты повторных переломов во всем мире создаются Службы профилактики повторных переломов (СППП). Одним из наиболее сложных разделов в организации работы СППП считается создание эффективно работающей системы длительного ведения пациентов. В данном процессе задействовано множество факторов, касающихся самого пациента, команды врачей-специалистов, особенностей организации медицинской помощи в первичном звене здравоохранения и многих других. С одной стороны, было показано, что включение пациентов с низкоэнергетическими переломами в СППП повышает их приверженность к выполнению рекомендаций врача. С другой, существует целый ряд барьеров, зависящих как от особенностей самого пациента (полиморбидность, тяжесть состояния, снижение когнитивной функции, страх перед развитием побочных эффектов, низкая мотивация к лечению остеопороза), так и от различных аспектов в организации медицинской помощи. В статье анализируется важность обучения пациентов и медицинского персонала, подходы к выбору терапевтической тактики, оптимизации процесса преемственного ведения больных, наличия системы передачи информации между медицинскими учреждениями. На примере работы СППП в г. Ярославле анализируются возможности совершенствования различных аспектов оказания помощи, а также локальные проблемы, возникавшие на различных стадиях формирования данной службы, и мероприятия, которые были применены для их разрешения.

To reduce the frequency of fragility fractures, Fracture Liaison Services are being created worldwide. One of the most difficult parts in their organization is considered to be the creation of an effective system of long-term patient management. Many factors are involved in this process, concerning the patient, the team of specialist, the peculiarities of the organization of primary health care, and many others. On the one hand, it has been shown that the inclusion of patients in FLS increases their commitment to the implementation of doctor’s recommendations. On the other hand, there are a number of barriers depending both on the characteristics of the patient himself (polymorbidity, severity of the condition, decreased cognitive function, fear of side effects, low motivation to treat osteoporosis) and on various aspects in the medical care organization. The article analyzes the importance of training patients and medical personnel, approaches to the choice of therapeutic tactics, optimization of the process of succession management of patients, the availability of a system of information exchange between medical institutions. Using the example of the Yaroslavl’ FLS, the possibilities of improving various aspects of medical care are analyzed, as well as local problems that arose at various stages of the development of this service, and the measures that were applied to resolve them.

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Best practice framework of fracture liaison services in Spain and their coordination with primary care. Arch Osteoporos. 2020;15(1):63. doi: https://doi.org/10.1007/s11657-020-0693-zГосударственный реестр лекарственных средств. Инструкция: Латинское название: Aclasta. Код АТХ: M05BA08. Действующее вещество: Золедроновая кислота (Zoledronic acid). Производитель: Novartis Pharma Stein AG (Швейцария). Доступно по: grls.rosminzdrav.ru. Ссылка активна на 16.01.23.Gosudarstvennyi reestr lekarstvennykh sredstv. Instruktsiia: Latinskoe nazvanie: Aclasta. Kod ATX: M05BA08. Deistvuiushchee veshchestvo: Zoledronovaia kislota (Zoledronic acid). Proizvoditel’: Novartis Pharma Stein AG (Shveitsariia) (In Russ.). Available at: grls.rosminzdrav.ru. Accessed 16.01.23.

The authors declare that there are no conflicts of interest present.