This guideline covers assessing the risk of fragility fracture in people aged 18 and over with osteoporosis. It aims to provide guidance on the selection and use of risk assessment tools in the care of adults at risk of fragility fractures in all NHS settings.

In February 2017, this guideline was updated to correct reference to the WHO in relation to the FRAX tool.

Recommendations

This guideline includes recommendations on:

Who is it for?

  • Healthcare professionals
  • Adults with osteoporosis and their families and carers

Is this guideline up to date?

We checked this guideline in January 2015. We will decide whether to update this guideline after a multiple technology appraisal which will update technology appraisals 160, 161 and 204 has been completed. 

Next review: To be scheduled

Guideline development process

How we develop NICE guidelines

This guideline was previously called osteoporosis: assessing the risk of fragility fracture.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.


Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)