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Prof Frances Dockery

Fracture Liaison Services Database Clinical Lead, Consultant Geriatrician, Beaumont Hospital

Osteoporosis is a chronic condition that causes the structure of our bones to become thinner. It causes bones to break or fracture more easily after a minor bump, fall or while carrying out everyday tasks.

A fracture caused by osteoporosis is called a fragility fracture. The most common fractures occur in the wrist, hip and back bones. With an estimated 300,000 people in Ireland having the condition, only 20% of cases are diagnosed.

Helping to prevent osteoporosis

“Anyone over the age of 50 who has broken or fractured a bone should view it as a potential warning for the condition,” says Professor Frances Dockery, the national clinical lead for Fracture Liaison Services (FLS) Database. She explains: “At least a third presenting with a fragility fracture to hospital say they had a fracture already but were not screened or treated for osteoporosis.

With an estimated annual direct and indirect cost of €450 million treating fractures in Ireland, it’s in the whole healthcare system’s interest to diagnose and treat the condition.” She advises people to take a ‘multi-pronged approach’ to reduce the chances of a fracture. “Smoking is a no-no, and excessive drinking is very bad for bone health. Regular weight-bearing exercise is a good idea as it improves bone density and muscle strength which can weaken with age,” she adds.

Steps to reducing re-fractures

The FLS identifies people with new fragility fractures, investigates them for osteoporosis and treats them if needed, as well as assessing a person’s falls risk. “Analysis of clinical trials about three years ago found that FLS markedly improves screening and treatment rates for osteoporosis as well as reducing the risk of another fracture in the future,” says Professor Dockery.

Moreover, patients are monitored for 12 months. Follow-up data shows that only half of people are still taking osteoporosis medication after a year, despite the fact that it has a significant role in reducing re-fractures,” she explains. “We continue to educate patients and work with them to take preventative measures including medication, diet and lifestyle changes.”

Rolling out support across Ireland

The National FLS Database monitors each hospital on how many patients with a fracture they are seeing versus how many they should be and how well they are managed. Professor Dockery concludes: “We are still only halfway to a fully funded FLS across Ireland. We would like it to be equal across Ireland. It should be the norm that every person with a fracture aged over 50 gets a comprehensive screening for osteoporosis and falls risk to reduce their chance of a repeat fracture ahead.”

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