porozendoОстеопороз и остеопатииOsteoporosis and Bone Diseases2072-26802311-0716Endocrinology Research Centre10.14341/osteo201423-6porozendo-8879Research ArticleСтатьиArticlesСИСТЕМА ПРОФИЛАКТИКИ ПОВТОРНЫХ ПЕРЕЛОМОВ: ПЕРВЫЕ ИТОГИ ПИЛОТНОЙ ПРОГРАММЫ В РАМКАХ ПРОЕКТА «ПРОМЕТЕЙ» В ГОРОДЕ ЯРОСЛАВЛЕREFRACTURE PREVENTION SYSTEM: FIRST RESULTS OF A PILOT PROGRAM WITHIN THE PROJECT «PROMETHEUS» IN YAROSLAVLБеловаК ЮBelovaK Yu

к.м.н., зав. центром остеопороза ГУЗ ЯО КБ СМП им. Н.В. Соловьева, ассистент кафедры терапии ИПДО ЯГМА

-ЕршоваО БYershovaO B

д.м.н., зам. главного врача по лечебной работе ГУЗ ЯО КБ СМП им. Н.В. Соловьева, профессор кафедры терапии ИПДО ЯГМА

yarosteoporosis@list.ruДегтяревА АDegtyarevA A

к.м.н., главный врач ГУЗ ЯО КБ СМП им. Н.В. Соловьева

-БеловМ ВBelovM V

к.м.н., зав. 7 отделением ГУЗ ЯО КБ СМП им. Н.В. Соловьева, доцент кафедры травматологии, ортопедии и ВПХ ЯГМА

-ГерасимовВ ОGerasimovV O

врач 3 отделения ГУЗ ЯО КБ СМП им. Н.В. Соловьева, аспирант кафедры травматологии, ортопедии и ВПХ ЯГМА

-ФедотовС ЮFedotovS Yu

аспирант кафедры терапии ИПДО

-ГУЗ ЯО КБ СМП им. Н.В. Соловьева; ЯГМАГУЗ ЯО КБ СМП им. Н.В. СоловьеваЯГМА201415122014172№2 (2014)36Copyright © Белова К.Ю., Ершова О.Б., Дегтярев А.А., Белов М.В., Герасимов В.О., Федотов С.Ю., 20142014Белова К.Ю., Ершова О.Б., Дегтярев А.А., Белов М.В., Герасимов В.О., Федотов С.Ю.Belova K.Y., Yershova O.B., Degtyarev A.A., Belov M.V., Gerasimov V.O., Fedotov S.Y.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.osteo-endojournals.ru/jour/article/view/8879

С целью снижения частоты возникновения повторных переломов у пациентов, получивших низкоэнергетический (остеопоротический) перелом, Международным фондом остеопороза инициирована программа «Ловушка для перелома». Были созданы стандарты Базы лучших практик (Best PracticeFramework) для оценки эффективности работы центров по профилактике повторных переломов, организующихся в различных странах. В 2012 году Российской ассоциацией по остеопорозу начат проект ПРОМЕТЕЙ («Создание системы Предупреждения пОвторных перелоМов у пациентов с осТеопорозом»). С целью реализации данной программы в городе Ярославле был проведен пилотный проект по созданию центра для профилактики повторных переломов у лиц, получивших остеопоротический перелом. В статье оценивается эффективность работы данного центра с использованием международных стандартов, выявляются основные проблемы и предлагаются пути их решения.

In order to reduce the incidence of recurrent fractures in patients that had already experienced low-energy (osteoporotic) fracture, the International Osteoporosis Foundation initiated the program «Capture the fracture». Established Best Practice Framework represents 13 standards to evaluate the effectiveness of the centers for the prevention of recurrent fractures, organized in different countries. In 2012 the Russian Association on Osteoporosis started the project PROMETHEUS [Creation the system to prevent recurrence of fractures in patients with osteoporosis]. In order to implement this program in the city of Yaroslavl we conducted a pilot project to establish a center for the prevention of recurrent fractures in patients who have received osteoporotic fracture. In this article we assess the effectiveness of the work of this center with the use of international standards, identify key problems and propose solutions.

PROMETHEUSosteoporosisCapture the fracturefracturesReferencesÅkesson K., Marsh D., Mitchell P.J. et al. and IOF Fracture Working Group. capture the Fracture: a Best practice Framework and global campaign to break the fragility fracture cycle. position paper. osteoporosis international With other metabolic bone diseases© The Author(s) 201310.1007/ s00198-013-2348-zÅkesson K., Marsh D., Mitchell P.J. et al. and IOF Fracture Working Group. capture the Fracture: a Best practice Framework and global campaign to break the fragility fracture cycle. position paper. osteoporosis international With other metabolic bone diseases© The Author(s) 201310.1007/ s00198-013-2348-zBogoch E.R., Elliot-Gibson V., Beaton D.E. et al. Effective initiation of osteoporosis diagnosis and treatment for patients with a fragility fracture in an orthopaedic environment. J Bone Joint Surg Am 2006; 88: 25-34.Bogoch E.R., Elliot-Gibson V., Beaton D.E. et al. Effective initiation of osteoporosis diagnosis and treatment for patients with a fragility fracture in an orthopaedic environment. J Bone Joint Surg Am 2006; 88: 25-34.Boudou L., Gerbay B., Chopin F. et al. Management of osteoporosis in fracture liaison service associated with long-term adherence to treatment. Osteoporos Int 2011; 22: 2099-2106.Boudou L., Gerbay B., Chopin F. et al. Management of osteoporosis in fracture liaison service associated with long-term adherence to treatment. Osteoporos Int 2011; 22: 2099-2106.Clunie G., Stephenson S. implementing and running a fracture liaison service: an integrated clinical service providing a comprehensive bone health assessment at the point of fracture management. J Orthop Nurs 2008; 12: 156-162.Clunie G., Stephenson S. implementing and running a fracture liaison service: an integrated clinical service providing a comprehensive bone health assessment at the point of fracture management. J Orthop Nurs 2008; 12: 156-162.Cooper M.S., Palmer A.J., Seibel M.J. Cost-effectiveness of the concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study. Osteoporos Int 2012. 23: 97-107.Cooper M.S., Palmer A.J., Seibel M.J. Cost-effectiveness of the concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study. Osteoporos Int 2012. 23: 97-107.Dell R., Greene D., Schelkun S.R., Williams K. Osteoporosis disease management: the role of the orthopaedic surgeon. J Bone Joint Surg Am 2008; 90(Suppl 4): 188-194.Dell R., Greene D., Schelkun S.R., Williams K. Osteoporosis disease management: the role of the orthopaedic surgeon. J Bone Joint Surg Am 2008; 90(Suppl 4): 188-194.Gallacher S.J. Setting up an osteoporosis fracture liaison service: background and potential outcomes. Best pract Res clin Rheumatol 2005; 19: 1081-1094.Gallacher S.J. Setting up an osteoporosis fracture liaison service: background and potential outcomes. Best pract Res clin Rheumatol 2005; 19: 1081-1094.Greene D., Dell R.M. outcomes of an osteoporosis disease-management program managed by nurse practitioners. J Am Acad Nurse pract 2010; 22: 326-29.Greene D., Dell R.M. outcomes of an osteoporosis disease-management program managed by nurse practitioners. J Am Acad Nurse pract 2010; 22: 326-29.Huntjens K.M., van Geel T.A., Blonk M.C. et al. Implementation of osteoporosis guidelines: a survey of five large fracture liaison services in the Netherlands. Osteoporos Int 2011; 22: 2129-2135.Huntjens K.M., van Geel T.A., Blonk M.C. et al. Implementation of osteoporosis guidelines: a survey of five large fracture liaison services in the Netherlands. Osteoporos Int 2011; 22: 2129-2135.Inderjeeth C.A., Glennon D.A., Poland K.E. et al. A multimodal intervention to improve fragility fracture management in patients presenting to emergency departments. Med J Aust 2010; 193: 149-153.Inderjeeth C.A., Glennon D.A., Poland K.E. et al. A multimodal intervention to improve fragility fracture management in patients presenting to emergency departments. Med J Aust 2010; 193: 149-153.International osteoporosis Foundation. capture the Fracture: a global campaign to break the fragility fracture cycle. 2012. http://www.worldosteoporosisday.org/ Accessed 17 Dec 2012International osteoporosis Foundation. capture the Fracture: a global campaign to break the fragility fracture cycle. 2012. http://www.worldosteoporosisday.org/ Accessed 17 Dec 2012Langridge C.R., McQuillian C., Watson W.S. et al. Refracture following Fracture Liaison Service assessment illustrates the requirement for integrated falls and fracture services. Calcif Tissue Int 2007; 81: 85-9.Langridge C.R., McQuillian C., Watson W.S. et al. Refracture following Fracture Liaison Service assessment illustrates the requirement for integrated falls and fracture services. Calcif Tissue Int 2007; 81: 85-9.Lih A., Nandapalan H., Kim M. et al. Targeted intervention reduces refracture rates in patients with incident non-vertebral osteoporotic fractures: a 4-year prospective controlled study. Osteoporos Int 2011; 22: 849-858.Lih A., Nandapalan H., Kim M. et al. Targeted intervention reduces refracture rates in patients with incident non-vertebral osteoporotic fractures: a 4-year prospective controlled study. Osteoporos Int 2011; 22: 849-858.Majumdar S.R., Johnson J.A., McAlister F.A. et al. Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture a randomized controlled trial. Can Med Assoc J 2008; 178: 569-575.Majumdar S.R., Johnson J.A., McAlister F.A. et al. Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture a randomized controlled trial. Can Med Assoc J 2008; 178: 569-575.McLellan A.R., Gallacher S.J., Fraser M., McQuillian C. The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 2003; 14: 1028-1034.McLellan A.R., Gallacher S.J., Fraser M., McQuillian C. The fracture liaison service: success of a program for the evaluation and management of patients with osteoporotic fracture. Osteoporos Int 2003; 14: 1028-1034.Murray A.W., McQuillan C., Kennon B., Gallacher S.J. Osteoporosis risk assessment and treatment intervention after hip or shoulder fracture-a comparison of two centres in the United Kingdom. Injury 2005; 36: 1080-1084.Murray A.W., McQuillan C., Kennon B., Gallacher S.J. Osteoporosis risk assessment and treatment intervention after hip or shoulder fracture-a comparison of two centres in the United Kingdom. Injury 2005; 36: 1080-1084.Premaor M.O., Pilbrow L., Tonkin C. et al. Low rates of treatment in postmenopausal women with a history of low trauma fractures: results of audit in a Fracture Liaison Service. QJM 2010; 103: 33-40.Premaor M.O., Pilbrow L., Tonkin C. et al. Low rates of treatment in postmenopausal women with a history of low trauma fractures: results of audit in a Fracture Liaison Service. QJM 2010; 103: 33-40.Sander B., Elliot-Gibson V., Beaton D.E., Bogoch E.R., Maetzel A. A coordinator program in post-fracture osteoporosis management improves outcomes and saves costs. J Bone Joint Surg Am 2008; 90: 1197-1205.Sander B., Elliot-Gibson V., Beaton D.E., Bogoch E.R., Maetzel A. A coordinator program in post-fracture osteoporosis management improves outcomes and saves costs. J Bone Joint Surg Am 2008; 90: 1197-1205.Wallace I., Callachand F., Elliott J., Gardiner p. An evaluation of an enhanced fracture liaison service as the optimal model for secondary prevention of osteoporosis. JRSM 2011; Short Rep 2: 8.Wallace I., Callachand F., Elliott J., Gardiner p. An evaluation of an enhanced fracture liaison service as the optimal model for secondary prevention of osteoporosis. JRSM 2011; Short Rep 2: 8.Wright S.A., McNally C., Beringer T., Marsh D., Finch M.B. Osteoporosis fracture liaison experience: the Belfast experience. Rheumatol Int 2005; 25: 489-490.Wright S.A., McNally C., Beringer T., Marsh D., Finch M.B. Osteoporosis fracture liaison experience: the Belfast experience. Rheumatol Int 2005; 25: 489-490.

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