Follow-up of your patient may be to discuss results, to choose the medication programme for your individual patient, to encourage compliance, to provide lifestyle advice or to manage recurrent fallers (see Bay Navigator Falls pathway - to follow).
Follow-up may also be required if your patient experiences further fracture. In this case please note:
By referral to the Fracture Prevention Service via an eReferral to Health in Ageing annotate referral with Fracture Prevention Service. This may be indicated because of factors such as:
Before referral, ensure that any causes of secondary osteoporosis are identified and managed optimally. Patients with severe and recurrent falls may be referred to the Health in Ageing Service.
Referral to the Fracture Prevention Service should include your patient's relevant bone health history and current medication list, and can be made by eReferral or in writing.
In addition to an estimate of bone mineral density, a number of other investigations may be useful. They should not be used routinely as they are expensive and may lead to unnecessary distress to your patients. A DEXA scan is not a mandatory prerequisite to starting your patient on anti-resorptive medication, especially for routine age-related osteoporosis in patients ≥ 75 years old.
The following investigations may be useful in most cases of suspected osteoporotic fracture:
The following investigations may be useful to detect underlying pathology other than osteoporosis:
The following investigations (specialist use only) may be useful in particularly complex cases to identify the current state of bone metabolism:
If you have concerns about the effectiveness of oral bisphosphonate treatment, consider IV Zoledronic Acid or consult with HIA Fracture Prevention Service for an opinion on the role of P1NP testing.
Repeat bone mineral density (BMD) scanning should generally not be repeated within 2 to 3 years from the last. Thereafter, repeat DEXA scanning may assist in trying to decide whether to stop, continue or change anti-osteoporosis medication after 3-5yrs of treatment.
Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.