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“Introduction Prevention of osteoporotic fractures depends on the identification of individuals

at risk for fractures, followed by interventions to reduce this risk, such as modification of lifestyle factors and use of bone-sparing medications [1, 2]. The presence of a low trauma fracture is a significant risk factor for predicting future fracture; about 50% of those that survive experience a subsequent fracture in 10 years [3]. Clinical practice guidelines state that a low trauma fracture should signal the opportunity to initiate osteoporosis treatment for prevention Dolutegravir supplier of subsequent fractures [1, 2]. Two systematic reviews concluded that despite the availability of effective treatment options, the majority of patients who experience a low trauma fracture are under-investigated and under-treated for osteoporosis, within Canada and internationally [4, 5]. This highlights an important care gap [6]. In Europe and North America, the care gap has resulted

in action plans to improve bone health [7–10]. One such plan, currently being implemented, is the Ontario Osteoporosis Strategy, a population-based chronic disease management program [10]. The overall goal is to reduce morbidity, mortality and costs from osteoporosis and related fractures by raising public awareness, changing knowledge, attitudes and behaviours of both the public and health professionals and improving prevention and treatment programs. Secondary fracture prevention is a major focus with a province-wide Fracture Clinic Screening Program implemented in 36 medium- and high-volume fracture clinics. Based on the Osteoporosis Exemplary Care Program developed by Bogoch et al.