Reprint of: The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide.
Elizabeth M Curtis, Rebecca J Moon, Nicholas C Harvey and 1 others
PMID 28578992WHAT IT FOUND
After a fragility fracture, many patients still do not receive osteoporosis treatment.
Fracture liaison services that include nurse specialists are described as a way to assess and treat, but thresholds vary by country.
Key findings
01In a study of over 60,000 older women in primary care across 10 countries, more than 80% of women with a fragility fracture did not receive osteoporosis treatment.
02FRAX estimates 10-year major osteoporotic and hip fracture probability for people aged 40-90 years, with or without bone density, and has sixty-eight country-specific calculators.
03Multidisciplinary fracture liaison services, including fracture liaison clinical nurse specialists, are described as the most successful systems for secondary fracture prevention.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a narrative review, so it does not report original methods or a new patient population. The supplied text does not include a systematic search, study selection, or quality assessment of the cited literature. Many cited estimates are older, and the review notes that more than 20% of studies in one hip fracture systematic review were conducted more than a decade previously. Fracture rates, risk tool outputs, and treatment thresholds vary by country, so local guidance and resources must be considered. The review describes fracture liaison services as successful systems, but it does not report a trial result showing fracture reduction in every setting.
The easy way to misread this
Do not read fracture liaison services or FRAX as proof that they reduce fractures in your clinic. The paper is a review and says local fracture risk, resources, and treatment thresholds must be considered.