Osteoporosis: assessing the risk of fragility fracture

Recommendation ID: CG146/5
Question: FRAX and QFracture in adults living in residential care:- What is the utility of FRAX and QFracture in detecting risk of fragility fracture in adults living in residential care?
Any explanatory notes (if applicable): Why this is important:- Care home residents are at high risk of fragility fracture. This is probably related to increased age and frailty with multiple comorbidities, which increase fracture risk. There is also evidence that care home residents have lower bone mineral density (BMD), with 70% assessed as having osteoporosis using densitometry criteria alone. However, tools such as FRAX and QFracture, which only estimate fracture risk up to the 9th decade and use 10-year fracture risk, may underestimate short-term risk in care home residents, who have a mean age of approximately 85 years and a life expectancy of less than 5 years.
A study is required to assess whether care home residents should have targeted fracture risk assessment and whether residents at higher risk of fracture can be identified, using FRAX or QFracture. This could result in a more effective and efficient strategy for fracture prevention, targeting health service resources on those at the very highest fracture risk.

Source guidance details

Is this a recommendation for the use of a technology only in the context of research?	No
Is it a recommendation that suggests collection of data or the establishment of a register?	No
Last Reviewed	04/09/2012