Approximately half of all patients who suffer a hip fracture have already sustained a previous fracture – a ’signal’ fracture – before breaking their hip. About 15% of hip fractures happen in patients who have already broken one hip.
Through targeted interventions in three priority areas, namely: fracture prevention, health professional education & outreach and patient education and self-management, it is possible to reduce the risk of hip and other osteoporotic fractures.
This is the goal of the Ontario Osteoporosis Strategy, which emerged from recognition by the Ministry of Health and Long-Term Care in 2000, that osteoporosis was an important public health concern and that a comprehensive prevention and management strategy was needed.
A provincially coordinated initiative aimed at managing osteoporosis, reducing osteoporotic fragility fractures and promoting bone health, the overall goal of the Ontario Osteoporosis Strategy is to reduce hip and other osteoporotic fractures in Ontario by 20% by 2020, a goal that is increasingly important in light of Ontario’s increasing aging population.
There is a huge care gap for Canadians who break a bone due to osteoporosis: 80% never receive appropriate osteoporosis care, leaving them at substantial risk for further costly, debilitating and often life‐threatening fractures.
The Ontario Osteoporosis Strategy, funded by the Ministry of Health and Long Term Care since 2005, works to reduce this care gap within Ontario. Its mandate is to reduce morbidity, mortality and costs from osteoporotic fractures using a patient-centred, multi-disciplinary approach that is integrated across healthcare sectors.
The OOS represents the vision and coordinated efforts of many groups, including the Ministry of Health and Long-Term Care (MOHLTC), Osteoporosis Canada, Ontario College of Family Physicians, McMaster University, Women’s College Hospital and St. Michael’s Hospital.
The Ontario Women’s Health Council provided the original ground work for the Strategy, launched and funded by MOHLTC in 2005. Two important consultations and resulting documents facilitated the development of the Strategy.
- A Framework and Strategy for the Prevention and Management of Osteoporosis (Ontario Women’s Health Council, 2000).
- The Osteoporosis Action Plan: An Osteoporosis Strategy for Ontario (Ontario Women’s Health Council Osteoporosis Action Plan Committee, February 2003). This document was submitted to the Ministry and received approval in March 2003.The stakeholders and professionals now implementing the Strategy work across the continuum of osteoporosis prevention, screening and management.
The Strategy aims at achieving its overall goal of reducing hip and other osteoporotic fractures in Ontario through targeted interventions in three key priority areas. These include:
Reducing the risk of hip and other osteoporotic fractures in Ontario.
To achieve this goal we identify at-risk patients in appropriate acute, primary care, long term care and community settings, facilitating their access to appropriate diagnostic testing, fracture risk assessment and osteoporosis care. We also promote integration of post-fracture care, rehabilitation and osteoporosis management for fracture patients in in-patient/acute care, rehabilitation, long term care, primary care and community settings and through transitions across care settings. And by facilitating access to specialist support locally or through telemedicine to ensure appropriate assessment and care of patients with complex needs and for patients in rural and remote areas.
Health Professional Education & Outreach
Increasing evidence-informed practice by health care professionals.
To achieve this goal we continue to develop educational tools, programs and resources for health professionals that help them apply and maintain best practices in the prevention, appropriate use of diagnostic and fracture risk assessment tools, treatment and management of osteoporotic fractures. We also facilitate the development and adoption of EMR-based assessment, tracking and monitoring tools to facilitate osteoporosis management in acute, family and long term care settings.
Patient Education & Self-Management
Increasing capacity of at-risk patients to understand and manage their fracture risk
To achieve this goal we improve patients’ (and their family and informal care providers) understanding of their fracture risk by promoting and facilitating opportunities for learning and applying self-management skills necessary to optimally benefit from self-management tools, programs and resources.