{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T02:06:28Z","timestamp":1771380388120,"version":"3.50.1"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen Inc.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"crossref"}]},{"name":"UCB"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Osteoporosis is a chronic underdiagnosed condition that weakens bone structure with\n\t\t\tincreased risk of fragility fractures. While the prevalence of osteoporosis is expected\n\t\t\tto increase due to demographic developments in many countries, there is found to be a\n\t\t\tserious treatment gap for patients. This is partly due to inadequate diagnostic\n\t\t\tprocedures at healthcare facilities. Considering this, there is a need to understand\n\t\t\tfactors that affect processes involving diagnosis and treatment in osteoporotic\n\t\t\tpatients. This study\u2019s primary aim is to explore the management of patients with\n\t\t\tfragility fractures and osteoporosis by conducting and analyzing semi-structured\n\t\t\tinterviews with healthcare professionals at a German maximum care provider. Insights\n\t\t\tfrom the interviews were used to map out the pathway of clinical care for patients and\n\t\t\tthe results suggest a multitude of factors including disease awareness, communication,\n\t\t\tand up-to-date information to be particularly important for increased treatment quality.\n\t\t\tFuture studies shall focus on improving generalizability and exploring the effectiveness\n\t\t\tof recently updated guidelines for management of osteoporosis.<\/jats:p>","DOI":"10.1055\/a-2658-0326","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T23:25:26Z","timestamp":1754695526000},"page":"52-61","source":"Crossref","is-referenced-by-count":0,"title":["Mapping the Clinical Care Pathway of Fragility Fracture Patients at a German Maximum Care Provider Through Qualitative Research"],"prefix":"10.1055","volume":"164","author":[{"given":"G\u00e1bor","family":"K\u00f6halmi","sequence":"additional","affiliation":[{"name":"Helios Health Institute, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Dirks","sequence":"additional","affiliation":[{"name":"Helios Health Institute, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorian","family":"Fass","sequence":"additional","affiliation":[{"name":"Helios Health Institute, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romy","family":"Bley","sequence":"additional","affiliation":[{"name":"RWE, UCB Pharma GmbH, Monheim am Rhein, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans Derk","family":"Pannen","sequence":"additional","affiliation":[{"name":"Medical Strategy, UCB Pharma GmbH, Monheim am Rhein, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Kuhlen","sequence":"additional","affiliation":[{"name":"Helios Health Institute, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Bollmann","sequence":"additional","affiliation":[{"name":"Helios Health Institute, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Voigt","sequence":"additional","affiliation":[{"name":"Clinic for Orthopedics, Trauma- and Hand Surgery, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clayton","family":"Kraft","sequence":"additional","affiliation":[{"name":"Clinic for Orthopedics, Trauma- and Hand Surgery, HELIOS Klinikum Krefeld, Krefeld, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1007\/s11657-020-0706-y","article-title":"Fragility fractures in Europe: burden, management and\n\t\t\t\t\topportunities","volume":"15","author":"F Borgstr\u00f6m","year":"2020","journal-title":"Arch Osteoporos"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1007\/s11657-020-00871-9","article-title":"SCOPE 2021: a new scorecard for osteoporosis in Europe","volume":"16","author":"JA Kanis","year":"2021","journal-title":"Arch Osteoporos"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1016\/S0140-6736(02)08657-9","article-title":"Epidemiology and outcomes of osteoporotic fractures","volume":"359","author":"SR Cummings","year":"2002","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s11914-009-0022-3","article-title":"Variation in risk factors for fractures at different sites","volume":"7","author":"JL Kelsey","year":"2009","journal-title":"Curr Osteoporos Rep"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1136\/bmj.333.7557.27","article-title":"Hip fracture","volume":"333","author":"M Parker","year":"2006","journal-title":"BMJ"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1726","DOI":"10.1007\/s00198-006-0172-4","article-title":"An estimate of the worldwide prevalence and disability associated with\n\t\t\t\t\tosteoporotic fractures","volume":"17","author":"O Johnell","year":"2006","journal-title":"Osteoporos Int"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.berh.2010.10.003","article-title":"Osteoporosis and fragility fractures","volume":"24","author":"L S\u00e0nchez-Riera","year":"2010","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s00198-020-05557-z","article-title":"The osteoporosis treatment gap in patients at risk of fracture in European\n\t\t\t\t\tprimary care: a multi-country cross-sectional observational study","volume":"32","author":"E McCloskey","year":"2021","journal-title":"Osteoporos Int"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2661","DOI":"10.1111\/ans.17876","article-title":"Implementation of a clinical pathway for osteoporosis management within an\n\t\t\t\t\tOrthopaedic Fracture Clinic","volume":"92","author":"S Narula","year":"2022","journal-title":"ANZ J Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1007\/s00113-008-1504-y","article-title":"Versorgungswirklichkeit bei osteoporosebedingten Frakturen in der\n\t\t\t\t\tdeutschen Unfallchirurgie. Ein Beitrag zur Versorgungsforschung","volume":"111","author":"T Vogel","year":"2008","journal-title":"Unfallchirurg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"20","DOI":"10.17169\/fqs-1.2.1089","article-title":"Qualitative Content Analysis","volume":"1","author":"P Mayring","year":"2000","journal-title":"Forum Qualitative Social Research"},{"key":"ref14","first-page":"72","article-title":"Where to start when everything feels urgent","volume":"43","author":"S Helmke","year":"2022","journal-title":"Learning Professional"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1007\/s00264-012-1482-0","article-title":"Knowledge of orthopaedic surgeons in managing patients with fragility\n\t\t\t\t\tfracture","volume":"36","author":"R Sorbi","year":"2012","journal-title":"Int Orthop"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1007\/s11657-024-01375-6","article-title":"Survey of awareness and attitudes to the management of fragility fractures\n\t\t\t\t\tamong the membership of the Asia Pacific Orthopaedic Association","volume":"19","author":"JK Lee","year":"2024","journal-title":"Arch Osteoporos"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1507","DOI":"10.1007\/s00198-016-3894-y","article-title":"Mind the (treatment) gap: a global perspective on current and future\n\t\t\t\t\tstrategies for prevention of fragility fractures","volume":"28","author":"NCW Harvey","year":"2017","journal-title":"Osteoporos Int"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1007\/s00198-022-06358-2","article-title":"Post-fracture care programs for prevention of subsequent fragility\n\t\t\t\t\tfractures: a literature assessment of current trends","volume":"33","author":"KE \u00c5kesson","year":"2022","journal-title":"Osteoporos Int"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1007\/s00198-015-3443-0","article-title":"Evidence of effectiveness of a fracture liaison service to reduce the\n\t\t\t\t\tre-fracture rate","volume":"27","author":"A Nakayama","year":"2016","journal-title":"Osteoporos Int"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s12877-020-01966-1","article-title":"Implementation of an integrated care programme to avoid fragility\n\t\t\t\t\tfractures of the hip in older adults in 18 Bavarian hospitals - study protocol\n\t\t\t\t\tfor the cluster-randomised controlled fracture liaison service\n\t\t\t\t\tFLS-CARE","volume":"21","author":"I Geiger","year":"2021","journal-title":"BMC Geriatr"}],"container-title":["Zeitschrift f\u00fcr Orthop\u00e4die und Unfallchirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2658-0326.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T01:45:48Z","timestamp":1771379148000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2658-0326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":18,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,2,13]]},"published-print":{"date-parts":[[2026,2]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2658-0326","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1864-6697","1864-6743"],"issn-type":[{"value":"1864-6697","type":"print"},{"value":"1864-6743","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]}}}