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Screening to reduce fragility fractures : new trials, still ineffective Therapeutics Initiative (University of British Columbia)

Description

Background: Fragility fractures cause significant morbidity that can decrease independence and are associated with premature death. Aims: This Therapeutics Letter summarizes the outcomes of screening programs designed to prevent fractures in older adults. To be effective, screening programs must reliably identify which healthy individuals are at high risk of a future condition, contribute to early, effective treatment for those who can benefit, and avoid treatment of people who are not likely to benefit. Conclusions: Large RCTs show that using screening tools such as bone mineral density (BMD) testing and fracture risk assessment (FRAX) don’t reliably predict who will have fragility fractures, often leading to overdiagnosis. Age, a history of falls, and use of certain drugs are much better risk predictors. Exercise, smoking cessation, and avoiding excessive alcohol or drugs that increase falls appear most likely to reduce fractures.

Item Metadata

Title
Screening to reduce fragility fractures : new trials, still ineffective
Alternate Title
Therapeutics Letter 147
Creator
Therapeutics Initiative (University of British Columbia)
Date Issued
2024-02
Description
Background: Fragility fractures cause significant morbidity that can decrease independence and are associated with premature death. Aims: This Therapeutics Letter summarizes the outcomes of screening programs designed to prevent fractures in older adults. To be effective, screening programs must reliably identify which healthy individuals are at high risk of a future condition, contribute to early, effective treatment for those who can benefit, and avoid treatment of people who are not likely to benefit. Conclusions: Large RCTs show that using screening tools such as bone mineral density (BMD) testing and fracture risk assessment (FRAX) don’t reliably predict who will have fragility fractures, often leading to overdiagnosis. Age, a history of falls, and use of certain drugs are much better risk predictors. Exercise, smoking cessation, and avoiding excessive alcohol or drugs that increase falls appear most likely to reduce fractures.
Subject
Age Factors; Bone Fractures; Drug-Related Side Effects and Adverse Reactions; Mass Screening; Osteoporosis; Overdiagnosis; Preventive Health Services; Risk Factors
Genre
Other
Type
Text
Language
eng
Notes
The UBC TI is funded by the BC Ministry of Health to provide evidence-based information about drug therapy. We neither formulate nor adjudicate provincial drug policies.
Date Available
2024-09-25
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0445448
URI
http://hdl.handle.net/2429/89289
Affiliation
Medicine, Faculty of; Anesthesiology, Pharmacology and Therapeutics, Department of
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International