National clinical guidance plays a vital role in advising health professionals on the measures they should take to prevent and treat ill-health. Whilst it is important to emphasise the use of clinical discretion by health professionals on a case by case basis, the development and implementation of appropriate, standardised guidance for the prevention, diagnosis, treatment and care of fragility fractures across the UK would represent an important step towards reducing the suffering and huge economic costs associated with fragility fractures.
There are a number of separate pieces of clinical guidance in place for the management of osteoporosis, applying to different areas of the UK, provided by the following organisations.
National Institute for Health and Clinical Excellence
The National Institute for Health and Clinical Excellence (NICE) produces guidance on health technologies and clinical practice for the NHS in England and Wales (although guidance is also commonly adopted in Scotland and Northern Ireland). The links below will take you to the patients and carer versions of published NICE guidance.
Clinical Guideline 146 Osteoporosis: assessing the risk of fragility fracture
Clinical Guideline 124 Hip fracture: The management of hip fracture in adults
Clinical Guideline 161 Falls: The assessment and prevention of falls in older people
Technical Appraisal 160 Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women
Technical Appraisal 161 Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women
Technical Appraisal 204 Denosumab for the prevention of osteoporotic fractures in postmenopausal women
All Wales Medicines Strategy Group
New medicines will be funded by NHS Wales following advice NICE and the All Wales Medicines Strategy Group (AWMSG). The AWMSG appraises new medicines for which no NICE guidance is expected for at least 12 months.
Click here for AWMSG recommendations
Scottish Intercollegiate Guidelines Network
The Scottish Intercollegiate Guidelines Network (SIGN) develops evidence based clinical practice guidelines for the National Health Service (NHS) in Scotland. The links below will take you to the full versions of published SIGN guidance.
Guideline 71: ‘Management of osteoporosis’
Guideline 71 is being updated to incorporate the significant advances in the management of this condition, including the arrival of new treatments and is due to be published in Spring 2014
Scottish Medicines Consortium
The Scottish Medicines Consortium (SMC) is provides advice to NHS Boards across Scotland about the clinical and cost-effectiveness of all newly licensed medicines, all new formulations of existing medicines and new indications for established products.
Click here to view SMC advice on osteoporosis treatments