The TARGET project in Tuscany: the first disease management model of a regional project for the prevention of hip re-fractures in the elderly.

BACKGROUND

The official inquiry on osteoporosis in Italy, promoted by the Italian Senate in 2002 concluded that proper preventive strategies should be adopted at regional level in order to prevent osteoporotic fractures. Tuscany is the first Italian region who has promoted an official program (the TARGET project) aimed to reduce osteoporotic fractures by ensuring adequate treatment to all people aged ≥65 years old who experience a hip fragility fracture.

OBJECTIVE

this paper provides information concerning the implementation of TARGET project in Tuscany, assuming that it may represent an useful model for similar experiences to be promoted in other Italian Regions and across Europe.

METHODS

we have examined the model proposed for the regional program, and we have particularly analyzed the in-hospital and post-hospitalization path of hip fractured patients aged >65 years old in Tuscany after the adoption of TARGET project by Tuscany healthcare system and during its ongoing start-up phase.

RESULTS

orthopaedic surgeons have been gradually involved in the project and are increasingly fulfilling all the clinical prescriptions and recommendations provided in the project protocol. Different forms of cooperation between orthopaedic surgeons and other clinical specialists have been adopted at each hospital for the treatment of hip fractured elderly patients. GPs involvement needs to be fostered both at regional and local level.

CONCLUSIONS

The effort of Tuscany region to cope with hip fractures suffered from elderly people must be acknowledged as an interesting way of addressing this critical health problem. Specific preventive strategies modelled on the Tuscany TARGET project should be implemented in other Italian regions.