Call to Action: a Five Nations Consensus on the Use of Intravenous Zoledronate After Hip Fracture

Overview

Journal Age Ageing

Publisher Oxford University Press

Specialty Geriatrics

Date 2023 Sep 30

PMID 37776543

Authors

Antony Johansen

Opinder Sahota

Frances Dockery

Alison J Black

Alasdair M J MacLullich

M Kassim Javaid

Emer Ahern

Celia L Gregson

Affiliations

Soon will be listed here.

Abstract

Currently in the UK and Ireland, after a hip fracture most patients do not receive bone protection medication to reduce the risk of refracture. Yet randomised controlled trial data specifically examining patients with hip fracture have shown that intravenous zoledronate reduces refracture risk by a third. Despite this evidence, use of intravenous zoledronate is highly variable following a hip fracture; many hospitals are providing this treatment, whilst most are currently not. A range of clinical uncertainties, doubts over the evidence base and practical concerns are cited as reasons. This paper discusses these concerns and provides guidance from expert consensus, aiming to assist orthogeriatricians, pharmacists and health services managers establish local protocols to deliver this highly clinically and cost-effective treatment to patients before they leave hospital, in order to reduce costly re-fractures in this frail population.

Citing Articles

Defining optimal orthogeriatric hip fracture care: a delphi consensus approach.

van Bremen H, Seppala L, Gans E, Hegeman J, van der Velde N, Willems H Eur Geriatr Med. 2025; .

PMID: 39909977 DOI: 10.1007/s41999-025-01156-5.

Assessing the impact of the 5 Nations Consensus Paper on IV Zolendronate administration post-hip fracture in older patients: experience from a UK teaching hospital.

Soopramanien J, Wakefield A, Marshall L, Nightingale J, Sahota O Osteoporos Int. 2024; 36(2):349-350.

PMID: 39496805 DOI: 10.1007/s00198-024-07303-1.

Following hip fracture, hospital organizational factors associated with prescription of anti-osteoporosis medication on discharge, to address imminent refracture risk: a record-linkage study.

Patel R, Judge A, Johansen A, Javaid M, Griffin X, Chesser T J Bone Miner Res. 2024; 39(8):1071-1082.

PMID: 38988134 PMC: 11337946. DOI: 10.1093/jbmr/zjae100.

Osteoporosis management in Australian aged care facilities: a mixed method study.

Laird C, Williams K, Benson H Arch Osteoporos. 2024; 19(1):37.

PMID: 38744716 PMC: 11093840. DOI: 10.1007/s11657-024-01401-7.

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