An international group of more than 40 of the top bone health experts, professional organizations, and patient advocacy groups dedicated to reducing secondary fractures, issued updated recommendations at the American Society for Bone and Mineral Research 2018 Annual Meeting in Montreal.
The recommendations outline the best course of care for women and men over 65 with a hip or spine (vertebral) fracture, and they were developed in response to an expected increase in hip fractures in high-risk patients with osteoporosis who are not being adequately treated. These are patients who haven’t been prescribed appropriate medications, as well as those who don’t take the drugs as directed, despite their effectiveness.
Only about 23 percent of older adults who experience a hip fracture are prescribed osteoporosis medication to reduce future risk, which is highest immediately after the first injury. Additionally, a 30-year downward trend in hip fractures in the United States has plateaued, possibly due to noncompliance with diagnostic and treatment guidelines.
Among the guidelines for those over 65:
- Communicate to patients and caregivers that a broken bone may mean they have osteoporosis and are at high risk for breaking more bones; fractures mean they may have to use a walker, cane, or wheelchair, or move to a residential facility, which will put them at higher risk for dying prematurely
- Make sure the patient’s primary health care provider knows about the fracture
- Regularly assess the risk of falling of women and men who have ever broken a hip or their spine; take a history of falls within the last year; minimize use of medications associated with an increased risk for falls; consider referring patients to physical and/or occupational therapists to improve mobility, gait, and balance, and reduce the risk for falls
- Offer osteoporosis medication therapy to anyone with a hip or spine fracture, to reduce their fracture risk; treat for osteoporosis regardless of bone mineral density testing results; routinely follow, re‐evaluate, and monitor for adverse treatment effects; and determine whether any changes in treatment should be made
Sourced from: The American Society for Bone and Mineral Research