How to implement guidelines and models of care

Geusens, P.; Appelman-Dijkstra, N.M.; Zillikens, M.C.; Willems, H.; Lems, W.F.; Bergh, J. van den (2022)

Article / Letter to editor

In subjects older than 50 years, the presence of clinical risk factors (CRFs) for fractures or a recent fracture is the cornerstone for case finding. In patients who are clinically at high short-and long-term risk of fractures (those with a recent clinical fracture or with multiple CRFs), further assessment with bone mineral density (BMD) measurement using dual-energy absorptiometry (DXA), imaging of the spine, fall risk evaluation and laboratory exami-nation contributes to treatment decisions according to the height and modifiability of fracture risk. Treatment is available with anti-resorptive and anabolic drugs, and from the start of treatment a lifelong strategy is needed to decide about continuous, intermit-tent, and sequential therapy. Implementation of guidelines re-quires further initiatives for improving case finding, public awareness about osteoporosis and national policies on reim-bursement of assessment and therapy.

• Fracture risk
• Fracture prevention strategy
• Anabolic drugs
• Anti-resorptive drugs
• Guideline implementation
• Vertebral fracture assessment
• Bone mineral density
• Fall risk

• All authors: Geusens, P.; Appelman-Dijkstra, N.M.; Zillikens, M.C.; Willems, H.; Lems, W.F.; Bergh, J. van den
• Date: 2022-09-01
• Journal: Best Practice and Research: Clinical Rheumatology
• Volume: 36
• Issue: 3
• DOI: doi:10.1016/j.berh.2022.101759