A new Canadian guideline recommends a risk assessment–first approach to fragility fracture screening before a bone mineral density test to facilitate shared decision-making. BoneDensity BMD
"These recommendations emphasize the importance of good clinical practice, where clinicians are alert to changes in physical health and patient well-being," the authors write."Clinicians should also be aware of the importance of secondary prevention and manage patients accordingly."
"This is an important topic," Grad said."Fragility fractures are consequential for individuals and for our publicly funded healthcare system. We anticipate questions from clinicians about the time needed to screen with the risk assessment–first strategy. Our modeling work suggests time savings with [this] strategy compared to a strategy of BMD testing first. Following our recommendations may lead to a reduction in BMD testing.
For example, Khan would like to see recommendations for younger women and for men of all ages regarding secondary causes ofor medications known to have a detrimental effect on bone health. By not addressing these patients, she said,"we may miss patients who would benefit from a fracture risk assessment and potentially treatment to prevent low-trauma fractures."
A recommendation for younger postmenopausal women was included in the most recent Society of Obstetricians and Gynaecologists CanadaOverall, she said,"I believe these recommendations will reduce the excess or inappropriate use of BMD testing and that is welcome." Funding for the Canadian Task Force on Preventive Health Care is provided by the Public Health Agency of Canada. The task force members report no relevant financial relationships.
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