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New guidelines for fracture prevention in LTC communities

September 22, 2015
by Nicole Stempak, Associate Editor
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Researchers issued new recommendations for preventing fractures among frail seniors in long-term care (LTC) facilities. The guidelines were published in the Canadian Medical Association Journal (CMAJ).

The authors sought input from LTC residents and their families, who cited pain management and maintaining mobility as top priorities for their loved ones.

“What is different about these guidelines is that we involved long-term care facility residents and family members in developing the recommendations,” says lead author Alexandra Papaioannou, MD, in a news release. “It is important that residents are involved in decision making around fracture management, and that these decisions consider a person’s health conditions and life expectancy.”

The 2015 recommendations take into account health conditions such as kidney function and ability to swallow and weigh the benefits and risks of each recommendation. The recommendataions build on Papaioannou’s 2010 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada, which focused on people living in the community and did not include seniors living in LTC settings.

“Our goal is to reduce the number of fractures and associated pain as well as to avoid transfers to hospitals to treat those injuries,” says Papaioannou, Professor of Medicine, McMaster University, and a geriatrician with Hamilton Health Services, Hamilton, Ontario.

The fracture rate for adults living in LTC is two to four times that of adults of similar age living in the community. One-third of older adults who experience hip fracture are LTC residents. Hip fracture is one of the most serious consequences of osteoporosis and one of the leading causes of hospital admission.

Recommendations are consistent with those issued by the American Medical Directors Association.