The following article is part of conference coverage from the 2018 American Society for Bone and Mineral Research (ASBMR) Annual Meeting in Montreal, Canada. Rheumatology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts on bone health. Check back for the latest news from ASBMR 2018 .

Recommendations to improve efforts to increase diagnosis and treatment of individuals who are at high risk for osteoporosis have been released at the American Society for Bone and Mineral Research (ASBMR) 2018 Annual Meeting, held September 28 through October 1, in Montreal, Quebec, Canada.

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The recommendations were developed by the ASBMR Secondary Fracture Prevention Initiative Coalition, which includes more than 40 of the world’s top bone health experts, physicians, specialists, and patient advocacy groups dedicated to reducing avoidable secondary fracture. They outlined the best course of clinical care for adults older than 65 years with a hip or vertebral spine fracture, in response to growing evidence of increased number of expected fractures and the high rate of patients at high risk for osteoporosis who are not receiving appropriate medication.

“I think many people are shocked to learn that these conversations are not happening and simple steps not being taken,” said Michael Econs, MD, president of ASBMR and division chief of the Division of Endocrinology and Metabolism and professor of medicine at the Indiana University School of Medicine. “As doctors, it’s our duty to help our patients and their loved ones understand what they can do to prevent another fracture. We must do a better job communicating with them and one another to help rein in this crisis.”

The following recommendations were developed by the coalition through a consensus-based process:

1. Clinicians should communicate 3 messages to patients and their caregivers throughout the fracture care and healing process:

  • Patients will be at high risk for subsequent fracture over the next 1 to 2 years.
  • Patients may need to use a walker, cane, or wheelchair, or move from their home to a residential faculty, and will also be at higher risk for mortality.
  • Patients can take action to reduce their risk for subsequent fracture.

2. The patient’s primary healthcare provider should be made aware of the fracture.

3. Clinicians should regularly assess the risk of falling in patients older than 65 years who have experienced a hip or spine fracture.

4. Patients older than 65 years with a prior hip or spine fracture should be offered pharmacologic therapy for osteoporosis to reduce the risk for subsequent fracture.

5. Patients in this age group with a prior fracture who are being treated for osteoporosis should receive routine follow-up.

The coalition emphasized that patients older than 65 years with a hip or spine fracture should be managed in a multidisciplinary clinical system that includes case management to ensure that patients are appropriately evaluated and treated for osteoporosis and risk for subsequent fracture.

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“All patients with hip or vertebral fractures need to be told that their broken bone most likely means they have osteoporosis and they are at very high risk for breaking more bones,” Dr Econs stated. “Our goal is for patients, families, and their healthcare professionals to understand this and take actions to prevent future fractures.”

For more coverage of ASBMR 2018, click here.


Patients 65 years of age or older who experience a hip or spine fracture should be treated for osteoporosis, says a global coalition of top bone health researchers, physicians, and patient advocacy organizations [press release]. Presented at: Annual ASBMR Meeting; September 28-October 1, 2018; Montreal, Canada.

This article originally appeared on Rheumatology Advisor