Guideline

Appendix B: How to use this Guideline

Osteoporosis management and fracture prevention in post-menopausal women and men > 50 years of age
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Appendix B: How to use this guide

Each of the 45 recommendations has been graded from A to D according to the process described in Appendix A. The grade reflects the degree of ‘trust’ that the clinician can place on the clinical application of the recommendation. The National Osteoporosis Guideline Review Committee supports all recommendations and intends they are used in conjunction with clinical judgement and patient preferences. The recommendations do not cover complex medical conditions and comorbidities, nor are they a substitute for individualised specialist advice and/or consultation. The Review Committee supports and encourages dialogue between GPs and specialists, if required for optimisation of patient care.

Recommendations marked with an asterisk (*) underwent a focused detailed published literature search by RACGP library staff, during which the following databases were interrogated to identify publications subsequent to the previous Edition, ie since 2016:

  • PubMed/Medline
  • NICE
  • United States Preventive Services Task Force
  • Cochrane database of systematic reviews
  • Canadian Task Force on Preventive Health Care
  • SIGN
  • Trip database
  • Google

These were then reviewed by a bone expert with subspeciality expertise in the topic and the relevant chapter(s) updated. The final draft of the chapter(s) underpinning that relevant recommendation(s) was then reviewed by the National Osteoporosis Guideline Review Committee and discussed at two face-to-face meetings.

All other recommendations have been updated by a bone expert with subspeciality expertise in the area and then reviewed by the National Osteoporosis Guideline Review Committee at two face-to-face meetings.

The practical tips are pointers to effectively implement recommendations. Unless otherwise referenced, the source of information presented in the practical tips is the National Osteoporosis Guideline Review Committee.
Side effects and adverse events are summarised for each pharmacological intervention. This guide does not seek to provide full safety and usage information on medications. The review committee also recommends consulting the Therapeutic Guidelines (www.tg.org.au), NPS MedicineWise (www.nps.org.au) or the Australian Medicines Handbook (https://shop.amh.net.au) for detailed prescribing information.
Each recommendation is supported by an updated critical appraisal of current evidence published since 2016. Appendix A describes the processes used to review the evidence.
  • Department of Health and Ageing; National Health and Medical Research Council. Nutrient reference values for Australia and New Zealand: Executive summary. Australian Government, 2006.
  • Department of Health and Ageing; National Health and Medical Research Council. Eat for health: Australian dietary guidelines. Summary. Canberra: Australian Government, 2013.
  • The Royal Australian College of General Practitioners (RACGP). Smoking, nutrition, alcohol, physical activity (SNAP): A population health guide to behavioural risk factors in general practice. 3rd edn. RACGP, 2015.
  • The Royal Australian College of General Practitioners (RACGP). Guidelines for preventive activities in general practice. 9th edn. RACGP, 2016.
  • The Healthy Bones Australia website (www.healthybonesaustralia.org.au) provides comprehensive, consumer-friendly information for people who have been diagnosed with osteoporosis, are at risk of osteoporosis or who wish to know more about bone health generally. A range of printable guides and factsheets translated into five languages is available to download from the website.
  • ‘Know your bones’ (www.knowyourbones.org.au) is a consumer-friendly, online bone health assessment tool based on the Garvan Fracture Risk Calculator.
  • Healthy Bones Australia provides a toll-free consumer helpline: 1800 242 141.
The review committee takes no responsibility for the information provided on these sites or via any links to which they may connect. URL addresses were accurate at time of publication.
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