Endocrinology and Metabolism
Making the first fracture the last - Development and long-term evaluation of a secondary fracture prevention program (SFPP) at Concord Hospital.
Osteoporosis is characterised by reduced bone strength, leading to increased fracture and re-fracture risk. Despite the availability of therapies that reduce re-fracture risk, most patients with osteoporosis do not receive appropriate treatment. An audit performed at Concord Hospital in 2004 revealed that only 7% of patients presenting with osteoporotic fractures were appropriately diagnosed and treated. Similar numbers were reported world-wide. Ten years later, 80% of Australian patients with osteoporotic fractures still go undiagnosed and untreated. This gap in post-fracture care leads to an unacceptably high rate of re-fractures, incurring unnecessary suffering to patients and their families, loss of life years, as well as immense cost to the health system and the wider community.
We established a Secondary Fracture Prevention Program (SFPP) at Concord Hospital in 2005 to improve the management of patients presenting with osteoporotic fractures. Over 4 years, the program reduced the incidence of re-fracture by 80% compared to standard care (4.1% vs. 19.7%; p<0.001). The service has had a positive impact on patient outcomes (Lih et al., 2011), is cost-effective (Cooper et al. 2012) and been transferred to other settings.
We are currently collecting 10-year data on all patients managed by the SFPP.
Establishment of a highly-effective SFPP at Concord Hospital. A similar service was created for Veterans and War Widows, with outreach clinics in Coffs Harbour, Port Macquarie and Nowra. Multiple publications, including an authoritative review/ meta-analysis and classification of SFPP programs worldwide (Ganda et al.2012)
- Prof Markus Seibel: Chair, National Alliance for Secondary Fracture Prevention (2016- )
- Prof Markus Seibel: Invited member, Publications Committee, American Society for Bone and Mineral Research (2015 – 2018)
- 2012 Sydney LHD Quality Award for the Concord Fracture Liaison Service (First Place, Category 'Keeping people healthy to avoid unnecessary hospitalization').
- 2012 New South Wales Health Award (formerly 'Baxter Award'), presented by the NSW Minister for Health and Medical Research
- 2012 Premier's Award, presented by the Premier of New South Wales
- 2013 National Lead Clinicians Group Awards for Excellence in Innovative Implementation of Clinical Guidelines
Higher Degree Students:
- Dr Kirtan Ganda
- CNC Fay Lang
- Ms Caroline Sullivan (until June 2017)
Publications and Presentations
- Held, F., Blyth, F., Gnjidic, D., Hirani, V., Naganathan, V., Waite, L., Seibel, M., Rollo, J., Handelsman, D., Cumming, R., Le Couteur, D. (2016). Association Rules Analysis of Comorbidity and Multimorbidity: The Concord Health and Aging in Men Project. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 71(5), 625-631.
- Gasparini, S., Weber, M., Henneicke, H., Kim, S., Zhou, H., Seibel, M. (2016). Continuous corticosterone delivery via the drinking water or pellet implantation: A comparative study in mice. Steroids, 116, 76-82.
- Daly, R., Ducher, G., Hill, B., Telford, R., Eser, P., Naughton, G., Seibel, M., Telford, R. (2016). Effects of a Specialist-Led, School Physical Education Program on Bone Mass, Structure, and Strength in Primary School Children: A 4-Year Cluster Randomized Controlled Trial. Journal of Bone and Mineral Research, 31(2), 289-298.
- Cooper, M., Seibel, M., Zhou, H. (2016). Glucocorticoids, bone and energy metabolism. Bone, 82, 64-68.
- Hirani, V., Naganathan, V., Blyth, F., Le Couteur, D., Seibel, M., Waite, L., Handelsman, D., Hsu, B., Cumming, R. (2016). Low Hemoglobin Concentrations Are Associated With Sarcopenia, Physical Performance, and Disability in Older Australian Men in Cross-sectional and Longitudinal Analysis: The Concord Health and Ageing in Men Project. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 71(12), 1667-1675.
- Noguchi, N., Chan, L., Cumming, R., Blyth, F., Handelsman, D., Seibel, M., Waite, L., Le Couteur, D., Naganathan, V. (2016). Lower Urinary Tract Symptoms and Incident Falls in Community Dwelling Older Men: The Concord Health and Ageing in Men Project. The Journal of Urology, 196(6), 1694-1699.
- Hakami, T., O'Brien, T., Petty, S., Sakellarides, M., Christie, J., Kantor, S., Todaro, M., Gorelik, A., Seibel, M., Yerra, R., et al (2016). Monotherapy with Levetiracetam Versus Older AEDs: A Randomized Comparative Trial of Effects on Bone Health. Calcified Tissue International, 98(6), 556-565.
- Noguchi, N., Blyth, F., Waite, L., Naganathan, V., Cumming, R., Handelsman, D., Seibel, M., Le Couteur, D. (2016). Prevalence of the geriatric syndromes and frailty in older men living in the community: The Concord Health and Ageing in Men Project. Australasian Journal on Ageing, 35(4), 255-261.
- Hsu, B., Seibel, M., Cumming, R., Blyth, F., Naganathan, V., Bleicher, K., Le Couteur, D., Waite, L., Handelsman, D. (2016). Progressive Temporal Change in Serum SHBG, But Not in Serum Testosterone or Estradiol, Is Associated With Bone Loss and Incident Fractures in Older Men: The Concord Health and Ageing in Men Project. Journal of Bone and Mineral Research, 31(12), 2115-2122.
- Hofbauer, L., Lecka-Czernik, B., Seibel, M. (2016). Sweet and brittle - Diabetes mellitus and the skeleton. Bone, 82, 1-1.
- Hsu, B., Cumming, R., Naganathan, V., Blyth, F., Le Couteur, D., Hirani, V., Waite, L., Seibel, M., Handelsman, D. (2016). Temporal Changes in Androgens and Estrogens are associated with All-Cause and Cause-Specific Mortality in Older Men. Journal of Clinical Endocrinology and Metabolism, 10(5), 2201-2210.
- Hsu, B., Cumming, R., Hirani, V., Blyth, F., Naganathan, V., Le Couteur, D., Seibel, M., Waite, L., Handelsman, D. (2016). Temporal Trend in Androgen Status and Androgen-Sensitive Outcomes in Older Men. Journal of Clinical Endocrinology and Metabolism, 101(4), 1836-1846.
- Sanders, K., Seibel, M. (2016). Therapy: New findings on vitamin D3 supplementation and falls-when more is perhaps not better. Nature Reviews Endocrinology, 12(4), 190-191.
- Tu, J., Zhang, Y., Kim, S., Wiebe, E., Spies, C., Buttgereit, F., Cooper, M., Seibel, M., Zhou, H. (2016). Transgenic Disruption of Glucocorticoid Signaling in Osteoblasts Attenuates Joint Inflammation in Collagen Antibody-Induced Arthritis. The American Journal of Pathology, 186(5), 1293-1301.
- Henneicke, H., Gasparini, S., Zhou, H., Hofbauer, L., Seibel, M. (2016). Zellulare Mechanismen der Gluko-kortikoid-induzierten Osteoporose und therapeutische Ansatzpunkte. Osteologie: interdisziplinaere Zeitschrift fuer Knochen und Gelenke, 25(4), 247-252.
Contact details for department
Head of Department: Prof Markus Seibel
Department/Unit: Endocrinology and Metabolism
Telephone: (02) 9767 6747
Facsimile: (02) 9767 7472