Background & Rationale

About the Fracture Screening & Prevention Program  (FSPP)


The Fracture Screening and Prevention Program (FSPP) is a secondary fracture prevention program developed through the Ontario Osteoporosis Strategy (OOS) and operated by Osteoporosis Canada in collaboration with the Ontario Orthopaedic Association, the Ontario College of Family Physicians and hospitals around the province.

Initiated in 2007, the goal of the Fracture Screening and Prevention Program (FSPP) is to increase the rate of referral of fragility fracture patients for assessment and treatment of osteoporosis in order to reduce the risk of re-fractures.

Twenty-five Fracture Prevention Coordinators (FPCs) work with 36 fracture clinics across Ontario to identify and assess men and women aged 50 and over who have had fragility fractures - broken bones - from incidents that would not normally cause bones to break, such as falling out of bed or slipping on ice.

Fracture Prevention Coordinators screen fragility fracture patients while working with orthopaedic surgeons, allied health professionals, diagnostic imaging, fracture clinic staff and primary care providers to help improve patient access to integrated and appropriate post-fracture care such as Bone Mineral Density testing and/or follow up with an osteoporosis specialist. The FPC also provides information and support to connect these patients with primary care, community-based services and education.

Objectives of the FSPP

  • Improve identification of at-risk patients and fracture risk assessment
  • Ensure appropriate use of diagnostic and assessment tools, including Bone Mineral Density (BMD) testing, to support fracture risk assessment and osteoporosis diagnosis
  • Improve quality of support provided to at-risk patients within fracture clinic settings
  • Promote integration of post-fracture care, rehabilitation and osteoporosis management for fracture patients in acute care settings
  • Facilitate access to local specialist support or through telemedicine to ensure appropriate assessment and care for patients with complex needs and for patients in rural/remote areas



Here are some important excerpts from the PHAC report:

  • “the absolute number of fractures of the forearm, hip, spine, humerus and pelvis increased over the 15-year surveillance period (from 95,000 in 2000-2001 to 132,000 in 2015-2016)”.  Go to page 35.
  • “Almost one-quarter (227.5 per 1,000 or 22.8%) of those who fractured a hip in 2014-2015 died of any cause within the following 12 months.”  Go to page 36.
  • “While women were 2 times more likely to fracture their hip, men were 1.3 times more likely to die of any cause within 12 months following their hip fracture.”  Go to page 36.
  • “A key finding of this report is that despite well-established clinical practice guidelines and initiatives to promote osteoporosis care, screening and treatment initiation rates following a fracture remain very low in Canada.”  Go to page 53.
  • “Within one year of fracture, less than 20% received an osteoporosis diagnosis, underwent a BMD test or received a prescription for an osteoporosis-related medication.”  Go to page 39.
  • “Irrespective of fracture site, men were less likely to receive a prescription than women.”  Go to page 44.
  • “Given the success of secondary fracture prevention and the resulting cost-saving benefits, increasing accessibility to FLS across the country may help to close the existing osteoporosis care gap.”  Go to page 46.

We urge you to read this very compelling and fact-based report regarding the state of osteoporosis care for Canadians who suffer a fracture.  It is available here.