Conclusions All interventions produced positive effects on BMD scanning and osteoporosis treatment rates post-fracture .
Despite sizeable increases , investigation and treatment rates remain sub-optimal .
Background There is a large quality of care gap for patients with osteoporosis .
As a fragility fracture is a strong indicator of underlying osteoporosis , it offers an ideal opportunity to initiate investigation and treatment .
However , studies of post-fracture population s document screening and treatment rates below 20 % in most setting s. This is despite the fact that bone mineral density ( BMD ) scans are effective at identifying patients at high risk of fracture , and effective drug treatments are widely available .
Effective interventions are required to remedy this incongruity in current practice .
Multinational, Placebo-Controlled, Randomized Trial of the Effects of Alendronate on Bone Density and Fracture Risk in Postmenopausal Women with Low Bone Mass: Results of the FOSIT Study

Abstract : This r and omized , double-masked , placebo-controlled trial evaluated the safety , tolerability and effects on bone mineral density ( BMD ) of alendronate in a large , multinational population of postmenopausal women with low bone mass . At 153 centers in 34 countries , 1908 otherwise healthy , postmenopausal women with lumbar spine BMD 2 st and ard deviations or more below the premenopausal adult mean were r and omly assigned to receive oral alendronate 10 mg ( n = 950 ) or placebo ( n = 958 ) once daily for 1 year . All patients received 500 mg elemental calcium daily . Baseline characteristics of patients in the two treatment groups were similar . At 12 months , mean increases in BMD were significantly ( p≤0.001 ) greater in the alendronate than the placebo group by 4.9 % ( 95 % confidence interval 4.6 % to 5.2 % ) at the lumbar spine , 2.4 % ( 2.0 % to 2.8 % ) at the femoral neck , 3.6 % ( 3.2 % to 4.1 % ) at the trochanter and 3.0 % ( 2.6 % to 3.4 % ) for the total hip . The incidence of nonvertebral fractures was significantly lower in the alendronate than the placebo group ( 19 vs 37 patients with fractures ) , representing a 47 % risk reduction for nonvertebral fracture for alendronate-treated patients ( 95 % confidence interval 10 % to 70 % ; p= 0.021 ) . Incidences of adverse events , including upper gastrointestinal adverse events , were similar in the two groups . Therefore , for postmenopausal women with low bone mass  , alendronate is well tolerated and produces significant , progressive increases in BMD at the lumbar spine and hip in addition to significant reduction in the risk of nonvertebral fracture
Conclusions All interventions produced positive effects on BMD scanning and osteoporosis treatment rates post-fracture .
Despite sizeable increases , investigation and treatment rates remain sub-optimal .
Background There is a large quality of care gap for patients with osteoporosis .
As a fragility fracture is a strong indicator of underlying osteoporosis , it offers an ideal opportunity to initiate investigation and treatment .
However , studies of post-fracture population s document screening and treatment rates below 20 % in most setting s. This is despite the fact that bone mineral density ( BMD ) scans are effective at identifying patients at high risk of fracture , and effective drug treatments are widely available .
Effective interventions are required to remedy this incongruity in current practice .