Exemplary SEIOMM-UFO programme to improve secondary fracture prevention in Spain

A unique nationwide initiative is successful in raising quality standards of Fracture Liaison Services in Spain.

IOF member SEIOMM (Sociedad Española de Investigación Ósea y del Metabolismo Mineral) is a multidisciplinary society dedicated to clinical care and basic and clinical research in the field of bone metabolism. The society, which in 2017 marks its 30th anniversary, has a tradition of promoting best practice, quality research and medical education on bone metabolism in Spain.

Spain is leading Europe in the number of Fracture Liaison Services (FLS) throughout the country. By the end of January 27, 2017, there were 33 clinics or hospitals listed in the Capture the Fracture® (CTF) Map of Best Practice, an online map which reflects FLS around the world that have signed up to IOF’s CTF programme.

A central component of the CTF programme is the ‘Best Practice Framework’ which sets standards of FLS best practice to which new and existing FLS should aspire. Notwithstanding the growing number of FLS in Spain, SEIOMM recognized that many of the FLS did not fulfill the standards of the Best Practice Framework. Also, a great majority of the FLS only addressed hip fractures and/or did not have the necessary foundation or experience in the prevention and treatment of osteoporosis and fractures.

This situation inspired SEIOMM to lead and support the improved development of FLS in Spain through a new programme: SEIOMM-UFO.


The objectives of SEIOMM-UFO are to optimize the secondary prevention of fragility fracture and ultimately to reduce the incidence of fragility fractures, through the creation of fracture units of high quality.

SEIOMM-UFO consists of 4 phases.

1. Advising and training: The aim of this first phase is to assure that new FLS coordinators and staff have a reference to address in case of doubt in the development of their FLS as well as to solve specific patient clinical issues. A contact address (coordinadorufo@gmail.com) is provided, so that questions from FLS administrators can be answered directly, or redirected to members of our panel of experts in FLS and osteoporosis.

SEIOMM-UFO has also organized training courses in secondary prevention of fracture and in the organization of FLS as well as small-format meetings to discuss more specific issues. One of the most important forms of training is mentoring: doctors and nurses interested in creating an FLS have the opportunity to spend a day in one well established FLS to experience its day-to-day functioning.

2. Providing the RHUFO resource: RHUFO is an online tool which provides support for the activities of SEIOMM-UFO affiliated FLS. RHUFO is not only a registry for data, it is a comprehensive resource which provides practical support for an FLS’ healthcare practice, and the control of excellence and research.

> View the short RHUFO video about the RHUFO dedicated website

3. Support grants: An FLS generates an increase in the workload of most units of bone metabolism because usually it involves attending to a new type of patients. The grants are intended to support the hiring of part-time nurses for a maximum of two years. The grants are renewed at 3, 6 and 12 months depending on the expansion of the type of fractures addressed by the FLS and the excellence of the data included in RHUFO.

4. Audit excellence: RHUFO includes a module, accessible only to SEIOMM-UFO coordinators, which shows the results regarding the quality standards of the Best Practice Framework of all of Spanish FLS working with RHUFO.

This unique programme gives all SEIOMM affiliated FLS the means to deliver high quality services to all, by:

  • Improving knowledge about secondary fracture prevention by means of advising and training.
  • Assuring communication between health care providers, medication review plan and long-term management by means of RHUFO.
  • Stimulating the inclusion of all fragility fractures and not only hip fractures by means of the support grants.

Since June 2016, when RHUFO was launched, 11 FLS (both new and established) have begun working with RHUFO and already more than 1500 fractured patients have been included in the programme. With RHUFO, more Spanish FLS will be in a position to achieve higher CTF ratings, including the highest  ‘Gold’ status, in recognition of programme excellence.

IOF and Capture the Fracture® congratulate SEIOMM-UFO for this outstanding initiative! With continued success, the initiative will certainly succeed in achieving its main objective of reducing the incidence of fragility fractures throughout Spain.