Osteoporosis in Primary Care

Primary care providers (PCPs) play a central role in the management of long-term conditions like osteoporosis. Given their ongoing relationship with patients, PCPs are ideally positioned to identify individuals at increased risk of fracture, initiate appropriate investigations, and provide long-term management. Priority patient groups include:

• Fragility fractures: Identify patients with a history of low-trauma fractures, particularly those involving the hip, spine, wrist, pelvis, or humerus. These fractures are strong indicators of underlying osteoporosis and signal an increased risk of future fractures.
• Medication-related bone loss: Assess patients who are on medications known to be associated with bone loss, such as glucocorticoids (used for 3 months or more), aromatase inhibitors, and androgen deprivation therapy. These medications can significantly increase the risk of osteoporosis and fractures.
• Conditions associated with bone loss: Evaluate patients with chronic inflammatory diseases like rheumatoid arthritis and chronic obstructive pulmonary disease, malabsorption conditions such as coeliac disease, diabetes, or cognitive impairments including dementia. These conditions are linked to an elevated risk of bone loss, falls and/or fractures.

Patients with fragility fractures, medication-related bone loss, and long-term conditions associated with osteoporosis are priorities for bone health assessment and management in primary care.