Recall

Bone health reviews

Ensure patients at risk of and those having osteoporosis are recalled annually for a comprehensive review as part of their long-term condition review or as a standalone review. Having the right diagnosis codes will help adding diary dates for recall (annual bone health reviews, DEXA scanning and treatment holidays/treatment pause).**

This could be done by a suitably trained allied health professional.

Suggested assessments to be completed at annual bone health review

Follow-up Osteoporosis assessment (including review of clinical risk factors, pain and disability)
FRAX or Q-Fracture probability score
Bisphosphonate medication review including side effects and contraindication
Assess for treatment failure and refer for specialist advice/consider alternate pharmacotherapy
Vitamin D and calcium medication review
Osteoporosis medication compliance review
Health education Osteoporosis (including signposting to exercises and rehabilitation programme)
Falls risk assessment – Using standard tools (e.g. FRAT) or developing a template from the following guidance;
- https://cks.nice.org.uk/topics/falls-risk-assessment
- https://www.nice.org.uk/guidance/cg161/evidence/falls-full-guidance-190033741

**https://cks.nice.org.uk/topics/osteoporosis-prevention-of-fragility-fractures/management/management/#follow-up

**https://www.sheffield.ac.uk/NOGG/NOGG%20Guideline%202017.pdf (section 7)