TY - JOUR T1 - Prevention and management of osteoporotic fractures by non-physician health professionals: a systematic literature review to inform EULAR points to consider JF - RMD Open JO - RMD Open DO - 10.1136/rmdopen-2019-001143 VL - 6 IS - 1 SP - e001143 AU - Nicky Wilson AU - Emailie Hurkmans AU - Jo Adams AU - Margot Bakkers AU - Petra Balážová AU - Mark Baxter AU - Anne-Birgitte Blavnsfeldt AU - Karine Briot AU - Catharina Chiari AU - Cyrus Cooper AU - Razvan Dragoi AU - Gabriele Gäbler AU - Willem Lems AU - Erika Mosor AU - Sandra Pais AU - Cornelia Simon AU - Paul Studenic AU - Simon Tilley AU - Jenny de la Torre AU - Tanja A Stamm Y1 - 2020/01/01 UR - http://rmdopen.bmj.com/content/6/1/e001143.abstract N2 - Objective To perform a systematic literature review (SLR) about the effect of non-pharmacological interventions delivered by non-physician health professionals to prevent and manage osteoporotic fractures.Methods Eight clinical questions based on two criteria guided the SLR: (1) adults≥50 years at high risk of osteoporotic fracture and (2) interventions delivered by non-physician health professionals to prevent and manage osteoporotic fractures. Interventions focused on diagnostic procedures to identify risk of falling, therapeutic approaches and implementation strategies. Outcomes included fractures, falls, risk of falling and change in bone mineral density. Systematic reviews and randomised controlled trials were preferentially selected. Data were synthesised using a qualitative descriptive approach.Results Of 15 917 records, 43 articles were included. Studies were clinically and methodologically diverse. We identified sufficient evidence that structured exercise, incorporating progressive resistance training delivered to people who had undergone hip fracture surgery, and multicomponent exercise, delivered to people at risk of primary fracture, reduced risk of falling. The effectiveness of multidisciplinary fracture liaison services in reducing refracture rate was confirmed. There was insufficient evidence found to support the effectiveness of nutrients and falls prevention programmes in this patient population.Conclusion Despite study heterogeneity, our SLR showed beneficial effects of some interventions delivered by non-physician health professionals and the positive impact of multidisciplinary team working and patient educational approaches to prevent and manage osteoporotic fractures. These results informed a EULAR taskforce that developed points to consider for non-physician health professionals to prevent and manage osteoporotic fractures. ER -