Osteoporosis management within UK care homes: a modified Delphi consensus

Osteoporosis is a chronic disease characterised by decreased bone mineral density (BMD) and increased fracture risk. Osteoporosis disproportionately affects residential care home populations.

To develop recommendations aimed at improving osteoporosis management in UK care homes.

Modified Delphi study of UK geriatric and osteoporosis care.

A steering group of six UK experts in geriatric medicine and osteoporosis care convened to discuss challenges in osteoporosis management within care homes. Forty-five consensus statements were developed and tested in a survey distributed to their peers (targeting 150 responses). Responders rated their agreement on a four-point Likert scale. Consensus was defined a priori as ≥75% strong agreement or very strong agreement as ≥90%. The group reconvened to analyse the results and generate recommendations.

In total, 101 survey responses were received from clinicians and care home managers representing all UK regions; 39.6% of responders had >20 years' experience in their role. Consensus was achieved for most (42/45 [93.3%]) statements and very high agreement achieved for two-thirds (66.7%). Therefore, the survey window was not extended to meet the response target. Nine recommendations to improve osteoporosis and bone health care across the UK primary care network were developed. These emphasise the need for coordinated referrals, treatment plans, and bone health education across primary and secondary care, including care homes. A potential care pathway was generated incorporating these recommendations.

Our study highlights gaps in osteoporosis care in UK care homes, including communication issues. A proactive approach to bone health is encouraged to improve patient outcomes and help alleviate the burden osteoporosis presents.