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Prevention and management of osteoporotic fractures by non-physician health professionals: a systematic literature review to inform EULAR points to consider

2020Journal article Open access
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dc.contributor.authorWilson, Nicky
dc.contributor.authorHurkmans, Emailie
dc.contributor.authorAdams, Jo
dc.contributor.authorBakkers, Margot
dc.contributor.authorBalážová, Petra
dc.contributor.authorBaxter, Mark
dc.contributor.authorBlavnsfeldt, Anne-Birgitte
dc.contributor.authorBriot, Karine
dc.contributor.authorChiari, Catharina
dc.contributor.authorCooper, Cyrus
dc.contributor.authorDragoi, Razvan
dc.contributor.authorGäbler, Gabriele
dc.contributor.authorLems, Willem
dc.contributor.authorMosor, Erika
dc.contributor.authorPais, Sandra
dc.contributor.authorSimon, Cornelia
dc.contributor.authorStudenic, Paul
dc.contributor.authorTilley, Simon
dc.contributor.authorde la Torre, Jenny
dc.contributor.authorStamm, Tanja A
dc.date.accessioned2020-05-12T10:19:15Z
dc.date.available2020-05-12T10:19:15Z
dc.date.issued2020
dc.description.abstractObjective 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. Methods 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. Results 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. Conclusion 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.pt_PT
dc.description.sponsorshipThis study was funded by the EULAR. Grant reference HPR 032.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1136/rmdopen-2019-001143pt_PT
dc.identifier.issn2056-5933
dc.identifier.urihttp://hdl.handle.net/10400.1/13874
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMJ Publishing Grouppt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectHip fracturept_PT
dc.subjectInterventionspt_PT
dc.subjectOccupational therapistpt_PT
dc.subjectFallspt_PT
dc.subjectNutritional supplementationpt_PT
dc.subjectFunctional mobilitypt_PT
dc.subjectElderly-womenpt_PT
dc.subjectOlder-adultspt_PT
dc.subjectRisk-factorspt_PT
dc.subjectExercisept_PT
dc.titlePrevention and management of osteoporotic fractures by non-physician health professionals: a systematic literature review to inform EULAR points to considerpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPagee001143pt_PT
oaire.citation.titleRMD Openpt_PT
oaire.citation.volume6pt_PT
person.familyNamePais
person.givenNameSandra
person.identifier.ciencia-id1F1A-ED3C-3260
person.identifier.orcid0000-0001-8472-4994
person.identifier.scopus-author-id56469150800
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationcc90b4e2-ac8a-41d3-afff-7e5d5392bfb7
relation.isAuthorOfPublication.latestForDiscoverycc90b4e2-ac8a-41d3-afff-7e5d5392bfb7

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