Friday, June 5, 2020
12.00pm - 1:00pm 

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Ontario College of Family Physicians 

CPD Program Coordinator
416-867-9646 ext. 20

Webinar: Clinical Application of the Long-Term Care Fracture Prevention Recommendations for Frail Older Adults

Date: Friday, June 5, 2020
Time: 12:00 p.m. - 1:00 p.m. 

Facilitators: Dr. Sid Feldman and Dr. Alexandra Papaioannou

After active engagement in this program, participants will be better able to:

  • Apply the LTC Fracture Prevention guideline recommendations.
  • Recognize challenges and barriers to implement the recommendations and use enablers.
  • Manage fracture prevention in high-risk patients with multiple chronic conditions..

Program Description:

Frail older adults at high risk for fracture in long-term care (LTC) face multiple challenges. Over 40% suffer from dementia, a similar percentage experience swallowing difficulties and over 20% may have renal insufficiency. Prior to the recent launch of the Fracture Risk Scale (FRS), which is automatically generated in the RAI-MDS 2.0, it was difficult to identify residents at high risk of fracture, as the exiting fracture risk assessment tools were not validated in LTC, where residents are more dependent, frail and vulnerable requiring more complex care than community dwelling older adults. While there are many interventions intended to reduce fracture risk, such as osteoporosis therapy, calcium and vitamin D supplementation, falls prevention and exercise prescription, these are not used consistently in long-term care.

Historically, clinical practice guidelines for osteoporosis have focused on the care of adults living in the community. In 2015, fracture prevention recommendations were launched specifically for LTC. This program aims to address existing care gaps by illustrating the application of pharmacological and non-pharmacological fracture prevention recommendations with frail older adults in LTC. These treatment recommendations, which were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, integrate falls and osteoporosis assessment, taking into consideration lifespan, renal impairment, and simultaneous risk of falls and fractures. Case study presentations will illustrate how to interpret Fracture Risk Scale scores and key issues associated with implementation of the guidelines and best approaches to managing LTC residents at high risk for fracture.

The program will also identify barriers and enablers to implement the recommendations (based on previous studies) and will provide examples of how to implement these based on research approaches that have been previously implemented and evaluated in the long-term care setting. This program will present a comprehensive approach to identify fracture risk and deliver non-pharmacological and pharmacological therapies to reduce immobility, pain and transfers to hospitals while improving the quality of life of residents in LTC.


This one-credit-per-hour Group Learning program has been certified by the College of Family Physicians of Canada and the Ontario Chapter for up to 1 Mainpro+ credit.


This program has received funding from the Ministry of Health and Long-Term Care as part of the Ontario Osteoporosis Strategy. This webinar has been developed and certified by the Ontario Osteoporosis Strategy for Long-Term Care. The OCFP is pleased to provide logistical support to enable its online delivery.