School of Health Sciences, University of Southampton, Southampton, UK.
Department Care I, Musculoskeletal System & Neurology, Dutch National Health Care Institute, Diemen, The Netherlands.
Ann Rheum Dis. 2021 Jan;80(1):57-64. doi: 10.1136/annrheumdis-2020-216931. Epub 2020 Apr 24.
To establish European League Against Rheumatism (EULAR) points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older.
Points to consider were developed in accordance with EULAR standard operating procedures for EULAR-endorsed recommendations, led by an international multidisciplinary task force, including patient research partners and different health professionals from 10 European countries. Level of evidence and strength of recommendation were determined for each point to consider, and the mean level of agreement among the task force members was calculated.
Two overarching principles and seven points to consider were formulated based on scientific evidence and the expert opinion of the task force. The two overarching principles focus on shared decisions between patients and non-physician health professionals and involvement of different non-physician health professionals in prevention and management of fragility fractures. Four points to consider relate to prevention: identification of patients at risk of fracture, fall risk evaluation, multicomponent interventions to prevent primary fracture and discouragement of smoking and overuse of alcohol. The remaining three focus on management of fragility fractures: exercise and nutritional interventions, the organisation and coordination of multidisciplinary services for post-fracture models of care and adherence to anti-osteoporosis medicines. The mean level of agreement among the task force for the overarching principles and the points to consider ranged between 8.4 and 9.6.
These first EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older serve to guide healthcare practice and education.
为非医师健康专业人员制定欧洲抗风湿病联盟（EULAR）考虑要点，以预防和管理 50 岁及以上成年人的脆性骨折。
根据 EULAR 为 EULAR 认可的建议制定的标准操作程序，由一个国际多学科工作组领导，该工作组包括患者研究合作伙伴和来自 10 个欧洲国家的不同卫生专业人员。为每个考虑要点确定了证据水平和推荐强度，并计算了工作组成员之间的平均一致性水平。
根据科学证据和工作组专家意见，制定了两项总体原则和七项考虑要点。这两项总体原则侧重于患者和非医师健康专业人员之间的共同决策以及不同非医师健康专业人员在预防和管理脆性骨折方面的参与。有四点考虑与预防有关：识别骨折风险患者、评估跌倒风险、预防原发性骨折的多组分干预以及劝阻吸烟和过度饮酒。其余三点侧重于脆性骨折的管理：运动和营养干预、多学科服务的组织和协调以用于骨折后护理模式以及抗骨质疏松药物的依从性。工作组对总体原则和考虑要点的平均一致性水平在 8.4 到 9.6 之间。
这些 EULAR 为非医师健康专业人员制定的第一个关于预防和管理 50 岁及以上成年人脆性骨折的考虑要点旨在指导医疗保健实践和教育。
