Authors
M Wang, A Auwyang, A Das, M J Seibel
Published in
Australian journal of primary health. Volume 32. Issue 4. Aug 17, 2026.
Abstract
Primary care plays a critical role in osteoporosis prevention and management. As part of a larger randomised controlled trial involving patients who had sustained a potential osteoporotic fracture, we asked general practitioners (GPs) about their perspectives on secondary fracture prevention.
The INTERCEPT trial, a cluster-randomised controlled trial, identified patients with potential minimal trauma fractures and alerted the patients' GPs to the fracture, along with best-practice guidelines for osteoporosis management. Four weeks following the alert, a survey assessed the GPs' views and decisions on osteoporosis-directed investigations and treatments.
Out of 170 responses, GPs considered 76 (44.7%) fractures as minimal trauma, 60 (35.3%) as not minimal trauma, and 34 (20%) as uncertain. Fractures were more likely to be considered minimal trauma if they involved the spine or if patients were older and/or female. A significant number of patients were not investigated or treated for osteoporosis despite the GP considering the fracture minimal trauma: only 44 of these 76 (57.9%) patients had a DXA (dual energy X-ray absorptiometry) scan, and less than half (n = 34) were commenced on osteoporosis-directed treatment. DXA T-scores above -2.5 s.d. or awaiting confirmation via a DXA scan were common reasons for not initiating treatment despite regarding the fracture as minimal trauma.
Rates of osteoporosis-directed investigations and treatment after minimal trauma fractures in primary care are below recommended levels. There remains a gap between observed management practices and established guidelines. A major barrier appears to be the reliance on DXA for confirmation of osteoporosis despite the presence of a minimal trauma fracture.
PMID:
42437684
Bibliographic data and abstract were imported from PubMed on 13 Jul 2026.
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