Osteoporosis and fragility fractures (OFF)

Leader: Dr Emma Clark and the OFF Group

Overall aims

This work stream aims too strengthen the fracture liaison services for primary and secondary fracture prevention, being implemented across North Bristol Trust and University Hospitals Bristol Trust. We’re also working to strengthen links with falls services and incorporate nurse led telephone consultations to check adherence with therapy. We also aim to strengthen local diagnostic services for osteoporosis, by co-ordinating the implementation of our recent research where we identified which patient groups benefit from vertebral morphometry to identify incidental vertebral fractures.

Projects and activities

We have successfully implemented the NHS best practice tariff for treating and caring for patients with fragility fractures. We have also developed patient-based quality indicators for the pan-Bristol bone-densitometry DXA scanning service, and have met with dentists and have discussed joint approaches to osteonecrosis of the jaw. We are working on incorporating vertebral fractures into the Bristol Fracture Liaison Service. Our research priority is improving adherence to osteoporosis medication.

Research in progress

  • Work on improving the pathway from occurrence of a vertebral fracture through to successful reduction in future fracture risk
    via appropriate interventions
  • Identification of exercise levels needed to maintain hip strength in older adults
  • Investigation of the association between failure of hip replacements and osteoporosis


Dr Emma Clark: Emma.Clark@bristol.ac.uk