This process was developed for Penrose Health, and is based on NICE guidelines from April 2023. You must have the appropriate training, use your clinical judgement, and escalate when necessary.
Summary
Osteoporosis is a condition that weakens bones, making them fragile and more likely to break. It develops slowly over several years, and is usually not diagnosed until a bone is broken. Women in particular lose bone rapidly in the first few years after menopause, and are at higher risk of osteoporosis.
An easily broken bone is usually the first sign of osteoporosis. The most common fractures in people with osteoporosis are wrist, hip and spinal bones. Spinal fractures make it difficult to support the weight of the body, resulting in a stooped posture in some older people in particular.
The Appointment
- Open the clinical template: ‘Osteoporosis (v17.9) (Ardens)’.
- Complete pg. 2 & 3 of the template.
- Assess fragility risk using FRAX or QFracture as per pg. 4 of the template.
- Provide lifestyle information and advice as per NICE guidelines
- Complete the remainder of the template, making appropriate referrals as below
- For BMI, refer to The Lambeth Healthy Weight Hub, Up! Up! Lewisham (Tier 2 Weight Management), NHS Tier 2 Weight Management Service or NHS Tier 3 Healthy Weight Programme as appropriate
- For smoking cessation, refer to Southwark Stop Smoking Service, Lewisham Stop Smoking Service or Lambeth Stop Smoking Service
If risk is at threshold for intervention, offer a DXA scan. If patient agrees, refer to GSTT Rheumatology, KCH Rheumatology or UHL Rheumatology