Prevention and management of osteoporotic fractures by non-physician health professionals: a systematic literature review to inform EULAR points to consider.
Accidental Falls
/ prevention & control
Bone Density Conservation Agents
/ therapeutic use
Dietary Supplements
Exercise
Health Personnel
Humans
Medication Adherence
Nurses
Nutritionists
Occupational Therapists
Osteoporosis
/ complications
Osteoporotic Fractures
/ etiology
Pharmacists
Physical Therapists
Practice Guidelines as Topic
Primary Prevention
Randomized Controlled Trials as Topic
health services research
multidisciplinary team-care
osteoporosis
Journal
RMD open
ISSN: 2056-5933
Titre abrégé: RMD Open
Pays: England
ID NLM: 101662038
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
05
11
2019
revised:
02
02
2020
accepted:
05
02
2020
entrez:
8
3
2020
pubmed:
8
3
2020
medline:
20
4
2021
Statut:
ppublish
Résumé
To perform a systematic literature review (SLR) about the effect of non-pharmacological interventions delivered by non-physician health professionals to prevent and manage osteoporotic fractures. Eight clinical questions based on two criteria guided the SLR: (1) adults≥50 years at high risk of osteoporotic fracture and (2) interventions delivered by non-physician health professionals to prevent and manage osteoporotic fractures. Interventions focused on diagnostic procedures to identify risk of falling, therapeutic approaches and implementation strategies. Outcomes included fractures, falls, risk of falling and change in bone mineral density. Systematic reviews and randomised controlled trials were preferentially selected. Data were synthesised using a qualitative descriptive approach. Of 15 917 records, 43 articles were included. Studies were clinically and methodologically diverse. We identified sufficient evidence that structured exercise, incorporating progressive resistance training delivered to people who had undergone hip fracture surgery, and multicomponent exercise, delivered to people at risk of primary fracture, reduced risk of falling. The effectiveness of multidisciplinary fracture liaison services in reducing refracture rate was confirmed. There was insufficient evidence found to support the effectiveness of nutrients and falls prevention programmes in this patient population. Despite study heterogeneity, our SLR showed beneficial effects of some interventions delivered by non-physician health professionals and the positive impact of multidisciplinary team working and patient educational approaches to prevent and manage osteoporotic fractures. These results informed a EULAR taskforce that developed points to consider for non-physician health professionals to prevent and manage osteoporotic fractures.
Identifiants
pubmed: 32144136
pii: rmdopen-2019-001143
doi: 10.1136/rmdopen-2019-001143
pmc: PMC7059534
pii:
doi:
Substances chimiques
Bone Density Conservation Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Medical Research Council
ID : MC_UP_A620_1015
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U147585827
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12011/2
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U147585819
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UP_A620_1014
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0400491
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U147585824
Pays : United Kingdom
Organisme : Department of Health
ID : 10/33/04
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12011/1
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Clin Rehabil. 2017 Feb;31(2):217-224
pubmed: 26825109
Osteoporos Int. 2009 Dec;20(12):2111-25
pubmed: 19421702
PLoS One. 2017 Jun 29;12(6):e0179867
pubmed: 28662153
Arch Phys Med Rehabil. 2010 Nov;91(11):1705-11
pubmed: 21044715
Arch Phys Med Rehabil. 2016 Jun;97(6):1013-25
pubmed: 26615791
Osteoporos Int. 2008 Jun;19(6):801-9
pubmed: 18030411
Age Ageing. 2008 Mar;37(2):167-72
pubmed: 18083724
Osteoporos Int. 2013 Oct;24(10):2555-60
pubmed: 23536256
World Health Organ Tech Rep Ser. 1994;843:1-129
pubmed: 7941614
Eur J Phys Rehabil Med. 2015 Feb;51(1):15-22
pubmed: 25184799
Lancet. 2015 Apr 25;385(9978):1623-33
pubmed: 25662415
BMC Geriatr. 2010 Aug 27;10:60
pubmed: 20799973
PLoS Med. 2008 Oct 14;5(10):e196
pubmed: 18922041
PLoS Med. 2009 Jul 21;6(7):e1000100
pubmed: 19621070
Arch Intern Med. 2002 Feb 25;162(4):450-6
pubmed: 11863479
Front Pharmacol. 2016 Aug 30;7:269
pubmed: 27625605
Bone. 2015 Feb;71:237-43
pubmed: 25451323
J Am Geriatr Soc. 1991 Feb;39(2):142-8
pubmed: 1991946
Arch Intern Med. 2010 Sep 27;170(17):1548-56
pubmed: 20876406
J Am Med Dir Assoc. 2017 Dec 1;18(12):1096.e19-1096.e26
pubmed: 29033325
BMC Geriatr. 2016 Dec 28;16(1):215
pubmed: 28031021
Eur J Orthop Surg Traumatol. 2013 Oct;23(7):737-45
pubmed: 23412217
J Women Aging. 2019 Mar-Apr;31(2):117-139
pubmed: 29319467
Bone. 2018 Jun;111:92-100
pubmed: 29555309
J Gerontol A Biol Sci Med Sci. 1995 Nov;50(6):M291-7
pubmed: 7583799
Br J Sports Med. 2016 Mar;50(6):346-55
pubmed: 26036676
J Orthop Trauma. 2014 Mar;28(3):e49-55
pubmed: 23912859
BMC Musculoskelet Disord. 2016 Aug 11;17:336
pubmed: 27515154
Cochrane Database Syst Rev. 2014 Apr 14;(4):CD000227
pubmed: 24729336
Cochrane Database Syst Rev. 2018 Jul 23;7:CD012221
pubmed: 30035305
Osteoporos Int. 2018 Jun;29(6):1227-1242
pubmed: 29460102
Osteoporos Int. 2015 Oct;26(10):2491-9
pubmed: 25963237
BMJ. 2017 Sep 21;358:j4008
pubmed: 28935701
Ann Intern Med. 2014 Nov 18;161(10):711-23
pubmed: 25199883
Osteoporos Int. 2018 Feb;29(2):265-286
pubmed: 29306984
Osteoporos Int. 2010 Oct;21(10):1637-56
pubmed: 20379700
Osteoporos Int. 2019 Jan;30(1):3-44
pubmed: 30324412
Osteoporos Int. 2011 Oct;22(10):2587-96
pubmed: 21720894
Public Health Nutr. 2004 Feb;7(1A):227-43
pubmed: 14972062
J Am Geriatr Soc. 2005 Sep;53(9):1618-22
pubmed: 16137297
J Physiother. 2014 Sep;60(3):168
pubmed: 25066936
Osteoporos Int. 2015 Sep;26(9):2243-8
pubmed: 26018089
Disabil Rehabil. 2017 Nov;39(22):2315-2323
pubmed: 27718643
J Gerontol. 1990 Nov;45(6):P239-43
pubmed: 2229948
Osteoporos Int. 2013 Dec;24(12):2907-18
pubmed: 23636230
Osteoporos Int. 2014 Jun;25(6):1807-12
pubmed: 24570297
Ann Rheum Dis. 2017 May;76(5):802-810
pubmed: 28007756
J Rehabil Med. 2008 Jun;40(6):446-50
pubmed: 18509559
Cochrane Database Syst Rev. 2014 Apr 29;(4):CD007768
pubmed: 24777444
Aust Fam Physician. 2013 Jun;42(6):423-7
pubmed: 23781552
J Bone Miner Res. 2014 Jan;29(1):182-91
pubmed: 23775701
Arch Osteoporos. 2018 Mar 21;13(1):33
pubmed: 29564735
Int J Geriatr Psychiatry. 2012 May;27(5):529-38
pubmed: 21732418
Osteoporos Int. 2013 Dec;24(12):2983-92
pubmed: 23652464
Maturitas. 2015 Dec;82(4):346-54
pubmed: 26386831
Rheumatology (Oxford). 2013 Mar;52(3):515-22
pubmed: 23192905
J Med Syst. 2017 Jun;41(6):96
pubmed: 28480481
J Am Geriatr Soc. 2010 Sep;58(9):1739-48
pubmed: 20863333
Clin Rehabil. 1999 Dec;13(6):509-17
pubmed: 10588538
Arch Osteoporos. 2013;8:136
pubmed: 24113837
Maturitas. 2015 Sep;82(1):85-93
pubmed: 26255681
Trials. 2015 May 12;16:214
pubmed: 25962885
Osteoporos Int. 2017 Jun;28(6):1779-1803
pubmed: 28236127
J Bone Miner Res. 2016 Dec 29;32(3):424-430
pubmed: 28099754
Cochrane Database Syst Rev. 2011 Jul 06;(7):CD000333
pubmed: 21735380
Age Ageing. 2013 Jan;42(1):39-45
pubmed: 22685164
Injury. 2014 Jan;45(1):265-71
pubmed: 23579066