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Osteoporosis guidelines updated for first time since 2017
The new guide will ‘make a real difference’ for the more than half of Australians aged over 50 with osteoporosis and osteopenia.
Changes to clinical practice and new developments in the pharmacological management of osteoporosis in the last six years have prompted the guidelines’ revision.
In partnership with Healthy Bones Australia, the RACGP has released its latest guidance on managing bone health, including osteopenia and osteoporosis, arming GPs with clear and evidence-based recommendations.
The third edition Osteoporosis management and fracture prevention in postmenopausal women and men over 50 years of age is the first update since 2017, following strong evidence supporting changes to clinical practice and new developments in the pharmacological management of the condition, particularly the role of osteoanabolic therapies.
RACGP President Dr Nicole Higgins welcomed the release, saying the new guide will support GPs to improve patient outcomes.
‘GPs play a vital role helping people with osteoporosis … a chronic disease which can lead to fractures,’ she said.
‘Risk factors can be investigated to help diagnose and manage osteoporosis to prevent this happening.
‘Many people, including those over 50 years of age, should be aware of their bone health due to the extent of this health issue with Australians living longer and our ageing population.
‘There has never been a more important time to help GPs care for people with osteoporosis and osteopenia.’
According to the latest figures from Healthy Bones Australia, more than 183,000 fractures occur each year across the country due to poor bone health, with the associated annual costs estimated to be $2.59 billion, accounting for 67% of the overall cost ($3.84 billion) of osteoporosis.
The national body also previously predicted that by 2022 more than six million people aged over 50 would have osteoporosis or osteopenia – an increase of 31% increase from 2012. Currently it is estimated that 1.2 million Australians have osteoporosis and a further 6.3 million have low bone density. Of those aged 50 years and over, 66% have osteoporosis or osteopenia.
For the 2024 update of the RACGP/Healthy Bones Australia guideline, a National Osteoporosis Guideline Review Committee was established to produce the latest evidence-based recommendations, content and statements across key topics constituting best practice in the identification, diagnosis, prevention and treatment of osteoporosis.
Associate Professor Peter Wong, Chair of the Guideline Review Committee, said the collaboration demonstrates a commitment to providing the most up-to-date advice for GPs and practice teams.
‘GPs have a range of effective solutions available to tackle this health issue,’ he said.
‘This new edition reflects latest peer-reviewed evidence and focuses on optimal management of osteoporosis in the community … providing clear guidance and recommendations on pharmacological management, use of fracture risk assessment tools, and the importance of calcium and vitamin D status in patients.
‘Each section … has been reviewed and updated by a bone expert with subspeciality expertise, to give GPs the highest standard of guidance and information.’
The guideline refresh is designed to support GPs’ clinical decision making with individual patients, rather than replace it, improving outcomes by the:
- prevention of first fracture
- early diagnosis of osteoporosis to allow prompt bone health management
- identification of undiagnosed patients following a first fracture to prevent subsequent fractures
- management of secondary causes of poor bone health.
The latest recommendations on pharmacological prevention and treatment of osteoporosis are divided under antiresorptive therapy (inhibits osteoclast activity) and osteoanabolic therapy (predominant stimulatory effect on osteoblasts).
It also includes a ‘special issues’ section featuring updated recommendations on delayed dental healing and the management of bone health in patients.
Chair of the RACGP Expert Committee – Quality Care, Professor Mark Morgan, said the guide includes the ‘best available advice’ for management of the condition.
‘This guide will make a real difference in the care and treatment of people with osteoporosis,’ he said.
‘We know our GPs do a tremendous job helping patients with these conditions and those at risk of developing them, and this guidance can act as a useful, extra tool to support clinical judgement on a patient-by-patient basis.’
Dr Higgins agrees the revamped guideline is a valuable general practice tool.
‘I congratulate and thank the authors of this guide and encourage all members to take a good look and share with their colleagues,’ she said.
All sections and appendices of the ‘Osteoporosis management and fracture prevention in postmenopausal women and men over 50 years of age’ guideline, as well as a downloadable PDF, are available on the RACGP website.
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