Position Statement on the Management of Osteoporosis (July 2019)
This position statement was issued following a National Forum with leading Australian clinical experts hosted by Osteoporosis Australia. The purpose of the statement is to provide GPs with clear guidance concerning identification, investigation and treatment of patients at risk for fragility fractures. The position statement compliments the current RACGP/OA clinical guidelines.
RACGP/OA Clinical Guidelines - Osteoporosis prevention, diagnosis and management in postmenopausal women and men over 50 years of age
Bone Density Testing Brochure for General Practice
(last updated 18th June 2018)
5 Common Myths De-Boned for General Practice
2019 Spring/Summer Issue
Garvan Fracture Risk Calculator
Web-based fracture risk calculators (FRCs) incorporate a number of clinical risk factors to estimate an individual’s percentage risk of fracture over the next 5 or 10 years. FRCs can help both GPs and patients recognise the magnitude of long term fracture risk. FRCs should be used in addition to, not instead of, current guidelines for treatment. FRCs can also help GPs more effectively communicate the need (or otherwise) for fracture-prevention treatment to patients.
The PBS rules for receiving a federal government subsidy for pharmaceutical treatment do not currently use a risk calculator approach. Eligibility for PBS subsidy is based on age, sex, T-score and occurrence of minimal trauma fracture.
Two FRCs are generally used in Australia, although others are available. The Garvan Bone Fracture Risk Calculator was developed by the Garvan Institute of Medical Research (Sydney) using data from the Dubbo Osteoporosis Epidemiology Study. This calculator estimates both 5 and 10 year risk of fracture, based on age, gender, number of fractures and number of falls. The FRAX © calculator was developed in the UK by a WHO Collaborating Centre team, and incorporates 10 clinical risk factors to estimate a 10 year risk of fracture only. Inclusion of a BMD measurement is optional for both calculators.
Different calculators will give different estimates of fracture risk. Currently, Osteoporosis Australia is unable to recommend the use of one calculator over another. Research is currently underway to determine the most appropriate use of fracture risk calculators in Australian general practice. A position statement and further guidance will be published as a result of this research.