Updates in the prevention of fractures

Abstract

BACKGROUND: The prevention of fractures is multifaceted and relies on reorienting lifestyles and targeting persons with increased fracture risk. Following an earlier review in 2017, the International Osteoporosis Foundation (IOF) has provided several updates for fracture prevention.

OBJECTIVES: This bibliographic review will provide family doctors with the IOF’s updates published on its website, noting changes to treatments and guidelines, addressing the prevention of fractures and discussing the new recommendations in the context of the Maltese healthcare system.

METHOD: The IOF website (https://www.osteoporosis. foundation/) was reviewed for guidance on preventing fractures from the 19th to the 27th of February 2023. The Scottish Intercollegiate Guidelines Network SIGN 2021 guidelines on managing osteoporosis and the UK Steady, Strong, Straight consensus statement were included. Updates in fracture prevention management were noted, and domestic practices and services available in the community were discussed.

RESULTS: The IOF promotes bone health through educational means, lobbying, and developing strategies, such as the Scorecard for Osteoporosis in Europe (SCOPE), which compares EU countries based on expenditure outcomes and accessibility to fracture prevention and management services. The review also emphasises using fracture risk calculators and densitometry to determine treatment and measure responses.

CONCLUSION: Strategies can reduce the risk of fractures by giving specific, measurable, and doable objectives to different stakeholders. For family doctors, this could involve community services in assessing the domestic milieu and improving access to social benefits and interventions. Home improvement measures improve both the risk and rate of falls while intervening on a personal level by improving physical and mental attributes to improve the rates of falls.