BMJ  2008;336:343 (16 February), doi:10.1136/bmj.39486.653009.3A

Letters

Preventing falls

Not at the expense of osteoporosis care

The first 150 words of the full text of this article appear below.

Järvinen et al remind us that falls assessment is too often ignored in people at high risk of fractures.¹ However, we believe that falls assessment and prevention must be in addition to, and not at the expense of, osteoporosis treatment. The British Orthopaedic Association advocates a dual approach to fracture prevention,² and indicators supporting both have been submitted for inclusion within the quality outcomes framework (QOF) in the UK.

We have high quality evidence for the secondary prevention of hip fractures with generic treatments endorsed as cost effective by the National Institute for Health and Clinical Excellence (NICE). We need more robust evidence linking falls interventions to the same outcomes. The studies listed by Järvinen et al do not support a claim for a 50% fracture reduction in community settings. This is the thrust of the paper by Gates and colleagues.³ Individual studies have shown that single and multifaceted interventions . . . [Full text of this article]

¹ Faculty of Education Health and Sciences, University of Derby, Derby DE22 1GB, ² Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB

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Shifting the focus in fracture prevention from osteoporosis to falls

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