PHARMACY TEAMS ARE UNIQUELY PLACED TO ENHANCE EARLY DETECTION AND SUPPORT PREVENTION


for bone mineralisation. Encouraging dietary sources and, when necessary, supplementation is key. The ROS toolkit emphasises calcium and vitamin D as foundational for good bone health1


programme combining FRAX and DXA to identify high-risk individuals earlier1


.


Lifestyle modification: Smoking cessation, limiting alcohol to within recommended limits, preserving healthy body weight, correcting vision, evaluating home-fall hazards and reviewing medications that increase fall risk all contribute meaningfully to fracture prevention3


.


Management: Diagnosis, Treatment & the Pharmacist’s Role Once osteoporosis or high fracture risk is identified, effective management spans diagnosis, pharmacotherapy, fall-prevention and long-term follow-up.


Diagnosis The gold standard for assessing bone density is dual-energy X-ray absorptiometry (DXA). Clinical risk-assessment tools such as FRAX estimate 10-year probabilities of hip or major osteoporotic fracture and guide decisions on scanning and treatment4


. New ROS research funding is exploring a UK-first targeted screening


.


Pharmacological therapy When indicated, antiresorptive treatments (e.g. bisphosphonates) and anabolic therapies (for very high risk) help reduce fracture incidence. Clinical guidelines recommend stratifying treatment based on fracture-risk category2


.


Falls–fracture link and prevention Preventing fractures includes the management of both bone strength and fall risk. Interventions such as balance-training, gait assessment, home hazard modification, vision assessment and medication review can help mitigate fall risk1


.


Community pharmacy contribution Pharmacists working in community settings are increasingly vital in osteoporosis care: • Risk-assessment and referral: Identifying at-risk individuals (e.g. those on long-term steroids, early menopause, smokers) and referring for bone-health assessment or DXA.


• Patient education: Communicating the importance of lifestyle change, adherence to treatment and early symptoms of bone fragility.


• Medication monitoring: Ensuring correct use of therapies (e.g. bisphosphonates), identifying side effects and supporting long-term adherence.


• Fall-risk reduction: Conducting medication reviews to spot drugs increasing fall risk (such as sedatives or antihypertensives), advising on vitamin D supplementation and liaising with other health professionals.


As accessible healthcare providers, pharmacists can influence behaviour, support ongoing monitoring and serve as a bridge between patients and other clinical services.


Emerging Research and the Future of Screening A compelling development in the osteoporosis landscape is the ROS-funded study aiming to build the case for the world’s first targeted screening programme for high fracture risk. Led by Professor Li Wei at University College London, the project will evaluate a pathway combining digital risk-preselection and DXA in under- researched groups including men, ethnic minorities and those in deprived areas1


.


This initiative speaks to the need for earlier identification and intervention – shifting the model from reactive to proactive. While UK national screening programmes for osteoporosis currently do not exist, NOGG (The UK National Osteoporosis Guideline Group) guidelines favour targeted case-finding and high-risk stratification4


.


Key Take-aways for Pharmacy Practice • Osteoporosis affects millions in the UK; proactive prevention and early management are essential.


• Lifestyle measures (diet, exercise, smoking cessation, alcohol moderation) underpin long-term bone health.


• Pharmacists should actively identify at-risk individuals, support risk-assessment pathways and collaborate in fall-prevention.


• Adherence to therapy and sustained patient engagement are crucial for effective fracture- risk reduction.


• Emerging screening research may reshape future pathways – community pharmacy must be ready to engage.


Sources: 1 Royal Osteoporosis Society; 2 Scottish Intercollegiate Guidelines Network - sign.ac.uk; 3 Queen Margaret University; 4 The UK National Osteoporosis Guideline Group (NOGG)


With Scotland’s ageing population and the associated rise in bone-health demands, pharmacy teams are uniquely placed to enhance early detection, support prevention and contribute to improved outcomes.


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