Open Access Open Badges Research article

The osteoporosis care gap in Canada

A Papaioannou1*, L Giangregorio2, B Kvern3, P Boulos1, G Ioannidis4 and JD Adachi1

Author Affiliations

1 Department of Medicine, McMaster University, Hamilton, Canada

2 Department of Kinesiology, McMaster University, Hamilton, Canada

3 Department of Family Medicine, University of Manitoba, Winnipeg, Canada

4 Charlton Medical Centre, Hamilton, Canada

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BMC Musculoskeletal Disorders 2004, 5:11  doi:10.1186/1471-2474-5-11

Published: 6 April 2004



The presence of a fragility fracture is a major risk factor for osteoporosis, and should be an indicator for osteoporosis diagnosis and therapy. However, the extent to which patients who fracture are assessed and treated for osteoporosis is not clear.


We performed a review of the literature to identify the practice patterns in the diagnosis and treatment of osteoporosis in adults over the age of 40 who experience a fragility fracture in Canada. Searches were performed in MEDLINE (1966 to January 2, 2003) and CINAHL (1982 to February 1, 2003) databases.


There is evidence of a care gap between the occurrence of a fragility fracture and the diagnosis and treatment of osteoporosis in Canada. The proportion of individuals with a fragility fracture who received an osteoporosis diagnostic test or physician diagnosis ranged from 1.7% to 50%. Therapies such as hormone replacement therapy, bisphosphonates or calcitonin were being prescribed to 5.2% to 37.5% of patients. Calcium and vitamin D supplement intake was variable, and ranged between 2.8% to 61.6% of patients.


Many Canadians who experience fragility fracture are not receiving osteoporosis management for the prevention of future fractures.

osteoporosis; fracture; Canada; diagnosis; treatment