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<p>Fracture liaison services (FLS) provide secondary prevention for fragility fractures.
These services identify patients in secondary and/or primary care who have suffered
a fragility fracture and assess the patient’s risk of future fragility fracture in
a timely fashion. A FLS then provides advice and/or therapy to reduce that risk.</p><p>
</p><p>The National Institute for Health and Care Excellence (NICE) evidence based
guideline <em>Osteoporosis: assessing the risk of fragility fracture</em>, updated
in February 2017, sets out best practice on management of fracture risk in patients
with osteoporosis. A copy of the guideline is attached. The guidance recommends that
clinicians consider assessment of fracture risk in all women aged 65 years and over
and all men aged 75 years and over. Women aged less than 65 years and men aged less
than 75 years should be considered for assessment in the presence of certain risk
factors, such as a family history of hip fracture or low body mass index.</p><p> </p><p>Regarding
bone density scanning, NICE recommends it be considered after patients have first
been assessed using a validated risk assessment tool, such as FRAX, which clinicians
can use to evaluate the 10-year probability of bone fracture risk in patient. The
guidance also recommends other circumstances where bone density scanning should be
considered, including for patients who are to undergo treatment which may affect bone
density, such as certain treatments for breast or prostate cancer.</p><p> </p><p>
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