National Osteoporosis Foundation supports new evidence-based vertebral compression fracture care pathway


Medtronic has announced that the National Osteoporosis Foundation (NOF) supports the vertebral compression fracture (VCF) Care Pathway, a new evidence-based clinical care pathway developed by a multispecialty panel of experts to ensure osteoporotic VCF patients receive timely and appropriate care.

The VCF Care Pathway, published in Spine Journal in 2018 and developed with grant support from Medtronic, is an algorithm that has the potential to be integrated into a hospital’s electronic medical record (EMR) system, ensuring patients who present with moderate or severe back pain as their primary or secondary complaint receive standardised treatment across all departments and healthcare providers, consisting of evidence-based care and follow-up.

The NOF believes that educating the healthcare community on appropriate patient care and working towards national standards are critical for advancing care of VCF patients. NOF has recently recorded and featured a discussion of the VCF Care Pathway on the NOF Bone Talk podcast.

“Our goal in working to integrate the VCF Care Pathway algorithm into commercially-available electronic medical records is to standardise and optimise care for VCF patients regardless of where in the care continuum they present.” said Joshua Hirsch, vice chair, Procedural Services and chief of the neurointerventional spine service at Massachusetts General Hospital and the lead author on the Spine Journal publication. “We believe optimising VCF patient care pathways on a macroscopic level will provide benefits at the patient level.”

A lack of consensus within the medical community and different levels of familiarity with the literature have made it challenging for healthcare providers to identify those VCF patients who may benefit from vertebral augmentation (VA) and those who could be appropriately managed with conservative care. The VCF Care Pathway is designed to systematically address this challenge.

The VCF Care Pathway was developed using the RAND/UCLA Appropriateness Method (RAM), a highly-structured approach for developing patient-specific recommendations that combines best available clinical evidence with the collective judgments of a multispecialty panel of experts. To develop the VCF Care Pathway, the panel considered 576 potential clinical scenarios.

“The NOF supports the development and implementation of the VCF Care Pathway,” said Elizabeth Thompson, CEO of the National Osteoporosis Foundation. “Identifying, diagnosing, and treating VCF patients in a timely and appropriate manner will have a critical impact on patients across the country. One in two women and one in four men over the age of 50 depend on the NOF to educate physicians about osteoporosis-related conditions and treatments, such as VCF, and to continue advocating for appropriate treatments that provide patients with the greatest likelihood of positive outcomes. We believe that the VCF Care Pathway is an important tool that can help achieve that objective, and we encourage its adoption and implementation.”


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