Osteoporosis screening and management framework for community-based primary care in Hong Kong: A Delphi consensus study

Abstract

Objectives

Osteoporosis poses a significant public health challenge as it leads to an increased incidence of fractures. This can result in considerable disability and substantial financial burdens. With the rapidly aging population in Hong Kong, the incidence and impact of osteoporotic fractures are expected to rise, underscoring the need for a coordinated, community-based care model to identify at-risk older adults and offer timely management.

Methods

This study adopted a Delphi methodology to develop consensus statements and a structured framework for community osteoporosis screening and management in Hong Kong. A multidisciplinary panel of 15 experts with experience in osteoporosis care in the primary care setting participated in three iterative rounds of surveys that collected anonymized ratings and feedback.

Results

A total of 31 consensus statements were established covering risk assessment, diagnosis, referral, and the care pathway of osteoporosis in the primary care setting. The statements provide practical recommendations for a systematic framework that streamlines workflow and delineates roles and responsibilities for primary care professionals and carers. This guidance is intended for primary care services, including community pharmacies, district health centers, and elderly service centers engaged in osteoporosis screening and management of individuals diagnosed with the condition.

Conclusions

The consensus recommendations advocate for the development of a sustainable, community-driven service framework that promotes routine risk assessment, timely initiation of treatment and coordinated long-term management. Implementation of this model has the potential to improve patient outcomes, reduce fracture-related morbidity, and alleviate the overall healthcare burden of osteoporosis in Hong Kong.