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Related Experiment Video

Updated: Dec 7, 2025

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Developing a Fracture Risk Clinical Assessment Protocol for Long-Term Care: A Modified Delphi Consensus Process.

Caitlin McArthur1, Loretta Hillier2, George Ioannidis1

  • 1McMaster University, Hamilton, Ontario, Canada; GERAS Centre for Aging Research, Hamilton, Ontario, Canada.

Journal of the American Medical Directors Association
|September 25, 2020
PubMed
Summary

A fracture risk Clinical Assessment Protocol (CAP) was developed for long-term care (LTC) settings. This evidence-based tool guides fracture prevention by embedding recommendations into routine clinical assessments.

Keywords:
Long-term careclinical assessment protocolfracture riskrecommendations

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Area of Science:

  • Gerontology
  • Bone Health
  • Clinical Practice Guidelines

Background:

  • Fracture prevention in long-term care (LTC) is crucial for resident well-being.
  • Existing guidelines require a standardized approach for effective implementation.

Purpose of the Study:

  • To develop a fracture risk Clinical Assessment Protocol (CAP).
  • To integrate LTC fracture prevention recommendations with a fracture risk assessment tool.

Main Methods:

  • A modified Delphi consensus approach was used.
  • Two survey rounds and a face-to-face meeting involved national experts and LTC stakeholders.
  • Consensus was sought on matching LTC fracture prevention guidelines to Fracture Risk Scale (FRS) levels.

Main Results:

  • Initial consensus was reached on 7 out of 14 guideline statements.
  • Revisions and further discussion led to consensus on all but one statement.
  • A key consensus was reached regarding pharmacologic therapy decisions, considering life expectancy among other criteria.

Conclusions:

  • An evidence-based fracture risk CAP for LTC was successfully developed.
  • The CAP is intended for integration into international routine clinical assessment tools.
  • This protocol aims to enhance fracture prevention strategies in long-term care settings.