26th January 2024

Follow up

Patients at risk of fragility fracture should be followed up regularly to check adherence to medication or development of any adverse effects. For patients taking oral glucocorticoids, pharmacological treatment with bisphosphonates and/or calcium and vitamin D should continue until the course of treatment is complete and then reassessed to determine whether this needs to be continued in high-risk patients. For all other patients, the need for treatment with bisphosphonates should be reviewed after 3-5 years. Patients who remain at high risk should be offered Alendronic acid for up to 10 years and risedronate for up to 7 years. For other patients, a repeat DEXA scan should be performed – if the T score is less than -2.5, treatment should be continued, and BMD should be rechecked every 3-5 years. If T score is greater than -2.5, treatment should be stopped and BMD re-measured after 2 years.