New Guideline Released for Skeletal Health and Fracture Prevention

November 8, 2023

Osteoporosis is a bone disease that develops when your bones become weaker and thinner, leading to decreased strength and a high risk of fractures or breaks. With more than 2.3 million Canadians living with osteoporosis, the Osteoporosis Canada 2023 Guideline Update Group has released an updated guideline for Canadian healthcare providers in the Canadian Medical Association Journal.

The guideline aims to support Canadian primary care providers in ensuring strong bone health and preventing fractures in postmenopausal women and men aged 50 and older.

“Building upon the foundation of the 2010 guidelines, numerous advancements have emerged over these 13 years, particularly in pharmacological therapy, fracture risk assessment and other nonpharmacological interventions for fracture prevention and osteoporosis management,” says Dr. Sandra Kim, division head of Endocrinology at WCH and co-author of the new guidelines. “New drugs have been introduced and concerns have arisen regarding the duration of therapy of some medications. This has led to confusion, not only among healthcare providers but also among patients. Given the prevalence of osteoporosis and the limited number of specialists available, our goal is to offer clearer guidance.”

Recommendations focus on areas including exercise, nutrition, fracture risk assessment, pharmacological interventions, therapy duration and more.

“These guidelines were developed with the collaboration of patients partners with lived experience and primary care physicians,” says Dr. Kim.

The team assessed over 1,000 patient input responses, employing the GRADE methodology in developing the updated guideline recommendations that considers benefits and harms, patient values and preferences as well as cost, feasibility and equity in the Canadian context.

“There are a lot of patients who fracture but only 20 per cent or less get assessed and treated for osteoporosis. About two-thirds of spine fractures go unnoticed or undiagnosed because they don’t necessarily present with pain,” she says. “But osteoporosis is akin to other chronic conditions like diabetes. It should be addressed in meaningful discussions between patients and primary care providers with the goal of preventing fractures and preserving autonomy and mobility through older adulthood. When developing an osteoporosis management plan, it is crucial to collaborate with the patient, which entails a thorough evaluation of risk factors and tailoring the treatment plan to their specific fracture risk.”

To read the full guidelines, click here.

Thank you, Dr. Kim!