Grant: Operating Grant

Until recently, fracture patients who broke a bone after falling from standing height or less were generally treated for bone health based on a diagnosis of osteoporosis (OP). Health care providers are now switching from telling their patients that they have OP, to telling their patients that they are at risk for future fracture. It is hoped that telling patients about their fracture risk, instead of their diagnosis of OP, will encourage them to accept treatment for their bone health. However, there are a number of challenges to switching to the concept of fracture risk. One main challenge is the assumption that patients will understand fracture risk and that they will perceive it as serious enough to take medication for their bone health. This study capitalizes on an existing bone health management program in an urban fracture clinic in Ontario where patients and their health care providers are told that the patient has a high chance of a future fracture. We will interview fracture patients, aged 50 and older, after they have been told about their fracture risk in the fracture clinic, and then after they have visited a bone specialist and/or their family physician. During the interviews, we will ask patients to explain their understanding of high fracture risk and whether they are doing anything about it, such as taking medication. Our research will inform the content and timing of future interventions to improve bone health. For example, interventions might address how we communicate fracture risk to patients and whether patients should be told about fracture risk in the fracture clinic or after they have visited their family physician. It is important that fracture patients who have a high risk for future fracture be treated for their bone health because appropriate treatment could prevent future fractures; this will alleviate fracture-related health care costs in Canada including admission to hospitals, extended care facilities, and nursing homes.