Introduction to the Ontario Osteoporosis Strategy

Introduction

The Ontario Osteoporosis Strategy (OOS) is a provincially funded initiative, operating since 2005, aimed at reducing fragility fractures and promoting bone health, with the overall goal of reducing hip and other osteoporotic fractures in Ontario.^1,3 Its mandate is to reduce the morbidity, mortality and costs associated with osteoporotic fractures.³

The need is substantial. One in three women and one in five men will experience a fragility fracture in their lifetime, and the risk of another fracture within a year of a vertebral or hip fracture is significantly elevated.² Critically, 40% of people who fracture a hip had a previous non-hip fracture that was not recognized as a warning sign of osteoporosis² — the “care gap” your screening role exists to close. And the strategy is working: since 2005, hip fracture rates have fallen in every age group, with the steepest decline — 25.1% — among Ontarians aged 65 to 79.³

2.1 About the OOS

The OOS is funded by the Ontario Ministry of Health and delivered through a coordinated network of clinical, academic and community partners.¹ Its objectives:¹

• Reduce osteoporotic fractures — decrease the incidence of hip and other osteoporotic fractures;
• Collaborative care — bridge care gaps with key partners such as the Ministry of Health, Osteoporosis Canada (OC) and leading hospitals;
• Education and evidence-based care — advance care through education, evidence-based solutions, and specialized programs for the elderly and long-term care (LTC).

2.2 Strategic Goals & Priority Areas

Two demographic pressures make this urgent:² by 2041 an estimated 25% of the population will be 65+ (4% aged 85+) with annual hip-fracture costs projected to reach $2.4 billion; and fragility fractures drive excess mortality, morbidity, chronic pain and institutionalization — each fracture raising the risk of the next.

2.3 Stakeholders and Partners

2.4 Programs and Services

Fracture Screening and Prevention Program (FSPP)

The FSPP — Ontario’s fracture liaison model — was established in 2007 for men and women aged 50+ with fragility fractures, in collaboration with OC, the Ontario Orthopaedic Association, the Ontario College of Family Physicians and hospitals across the province.⁴ It is delivered by 25 Fracture Prevention Coordinators (FPCs) across 36 fracture clinics (some based in Family Health Teams), collaborating with orthopaedic surgeons, allied health, diagnostic imaging, clinic staff and primary care.⁴

Long-Term Care, education and communications

The OOS LTC program supplies clinical tools and guidelines, staff education, and resident resources including falls-prevention programming.⁴ Beyond the Break delivers virtual education webinars; the EMR Osteoporosis Toolkit provides screening forms for OSCAR, PS Suite and Accuro; Fracture Link is the program newsletter; and Ontario clinics can order free pads of Your Guide to Strong Bones and Too Fit to Fracture.³

BoneFit™

BoneFit™ is an evidence-informed exercise training workshop for healthcare professionals and exercise practitioners working with people with osteoporosis.⁵ Delivered in-person and virtually with an emphasis on safety, it has run 90+ workshops, trained ≈2,000 professionals, across 60 locations in Canada.⁵

2.5 Websites

• Ontario Osteoporosis Strategy: osteostrategy.on.ca
• Find an FSPP site: osteostrategy.on.ca/find-an-fspp-site
• Beyond the Break webinars: osteostrategy.on.ca/btb-main
• BoneFit™: bonefit.ca · Locator map: bonefit.ca/bonefit-map-locator

Summary — Key Takeaways

• The OOS (since 2005, provincially funded) exists to reduce the morbidity, mortality and costs of osteoporotic fractures.^1,3
• Priority areas: fracture prevention · health professional education & outreach · patient education & self-management.²
• 40% of hip fracture patients had a prior, unrecognized fracture — the care gap your role closes.²
• The FSPP (est. 2007): 25 FPCs, 36 fracture clinics, adults 50+ with fragility fractures.⁴
• Stakeholders: Ministry of Health, OC, McMaster, Women’s College, Unity Health, Ontario Orthopaedic Association, OCFP, Geras Centre.¹
• BoneFit™ trains professionals in safe exercise for low bone mass — with a public locator map for referrals.⁵
• Ontario hip fracture rates: down in every age group; −25.1% in ages 65–79 since 2005.³