Digital integration and sociocultural tailoring in standardized care-FracTurk: the national digital fracture liaison service database by the Turkish Osteoporosis Society

Abstract

The FracTurk database integrates fracture liaison services with cultural and clinical practices in Türkiye, enhancing post-fracture care through digital tools. By tailoring treatment to the local context, it improves patient outcomes and reduces costs, with the potential to serve as a global model for culturally adapted healthcare solutions.

Background: Fracture liaison services (FLS) are specialized programs that aim to identify, treat, and manage patients who have experienced fragility fractures, with the overarching goal of preventing future fractures. Recognizing the need for a culturally appropriate and coordinated approach, the Turkish Osteoporosis Society has developed FracTurk, a national digitized FLS database tailored to the unique cultural, socioeconomic, and healthcare landscape of Türkiye. This paper provides an overview of the FracTurk system, detailing its development, potential benefits, and significance while also offering insights into future considerations for this initiative. By prioritizing digitalization and standardization within the FLS system, we aimed to pave a smooth patient pathway, ensuring a seamless journey through post-fracture care.

Material and methods: The FracTurk database was developed through a systematic process that involved the standardization and digitalization of patient follow-up forms and clinical practices across various institutions in Türkiye with international guidelines under the supervision of mentors certified by the International Osteoporosis Foundation, Capture the Fracture Initiative, which has been active for over 10 years in many countries. Additionally, the system incorporates clinical decision support tools and is customized to align with the Turkish cultural and healthcare landscape.

Results: Since its launch, the FracTurk database has been actively utilized by 25 users across 23 centers, with over 731 registered patients. The system continues to expand, demonstrating high levels of adoption and growth, indicating its increasing relevance and impact within the Turkish healthcare system. During the launch, the major difficulties and limitations encountered by the centers were discussed.

Conclusion: FracTurk constitutes a noteworthy step forward in digitizing and adapting FLS to the Turkish context. Although obstacles exist regarding data standardization and ensuring equitable access, the database demonstrates promise in enhancing patient outcomes, lowering healthcare expenditures, and serving as a template for other countries to emulate.

Keywords: Cultural adaptation; FracTurk; Fracture liaison service; Healthcare database; Osteoporosis.