Recommendations for the prevention of fragility fractures: a consensus from international experts and Ibero-American scientific societies

Abstract

Purpose To develop a multidisciplinary consensus outlining key recommendations to prevent fragility fractures and improve care through coordinated efforts across healthcare sectors.

Methods An international group of experts, coordinated by the Spanish National Hip Fracture Registry (RNFC), engaged over 300 professionals and 31 scientific societies. Using a nominal group technique, the committee reviewed scientific evidence and collaboratively developed ten core recommendations. The consensus was refined through multiple telematic reviews and finalized at the 7th RNFC Annual Meeting in March 2024.

Results The consensus presents ten actionable recommendations: (1) inclusion of osteoporosis and fragility fractures in health policies, (2) early detection and management of frailty and falls, (3) implementation of clinical practice guidelines, (4) promotion of fracture registries and audits, (5) support for Orthogeriatric Units and Fracture Liaison Services (FLS), (6) adoption of a “Fragility Fracture Code,” (7) empowerment of Primary Care in fracture prevention, (8) increased patient association involvement, (9) public awareness campaigns, and (10) promotion of research including patient-reported outcomes.

Conclusions Fragility fractures are a major public health issue with rising incidence, disability, and healthcare costs. This consensus offers unified, evidence-based guidance for policy makers, healthcare professionals, and patient organizations. Broad dissemination and implementation of these recommendations aim to reduce fracture rates and enhance patient outcomes through coordinated, multidisciplinary care.