Improving Quality of Care for Canadians at High-Risk for Fractures: A Knowledge to Action Approach

About 10% of Canadians 40 years of age or older have osteoporosis, a disease that causes brittle bones that make people prone to fracture. About one in five people 40 years of age or older have fractured their wrist, upper arm, spine, pelvis or hip. The likelihood of breaking a bone increases if you are older, have fallen in the past, already had a fracture, have certain medical conditions or have low bone density or osteoporosis. The worst type of fracture is a hip fracture which could lead to death, admission to a nursing home or difficulty carrying out regular daily activities. A hip fracture is preventable. While progress has been made in the prevention, diagnosis and treatment of osteoporosis, as in many areas of health care, there are disconnects or care gaps between what we know and the care that is actually delivered. Our research will focus on three major osteoporosis and fracture care gaps in order to improve quality of care for Canadians who are at high risk for their first fracture or who have already had a fracture. Focusing on preventing the first fracture, the program will study how to improve communication between patients and family doctors about the risk of having a fracture. We will also develop tools to help family doctors determine who is at high risk. Focusing on preventing the next fracture, the program will examine the safety and effectiveness of drugs used to treat osteoporosis. Recently there have been reports in the media questioning their safety. We will conduct research to help the public and health care providers better understand risks associated with these medications. Finally, we will look at improving care in the hospital, during rehabilitation and in the community following a hip fracture. We will look at creative ways to prevent falls using computer technology. In all cases we will seek to reduce care gaps through innovative and improved communication of research results to patients, health care providers and policy-makers.