Coordinated Osteoporosis Management in Primary Care to Prevent Fragility Fractures

Authors

• Lindsey M. Lybarger, University of LynchburgFollow

Specialty

Family Medicine

Abstract

Osteoporosis remains commonly underdiagnosed and undertreated in postmenopausal women following a fragility fracture, largely due to fragmented transitions from acute to primary care that delay evaluation, treatment initiation, and long-term management. This literature review evaluated evidence supporting a coordinated, multimodal approach to osteoporosis management in primary care that integrates pharmacological therapy, hormone replacement therapy, and exercise-based interventions. PubMed/MEDLINE, the Cochrane Library, Google Scholar, and professional organization resources were searched for English-language evidence published from January 2021 through June 2026. The evidence showed that pharmacological therapy remains the foundation of osteoporosis management, though its effectiveness depends on timely initiation, adherence, monitoring, and medication sequencing. Hormone replacement therapy should be recommended for appropriate patients. High-intensity resistance and impact exercise have complementary benefits, including improving bone mineral density and mobility and reducing fall risk. Coordinated care models will support the delivery of evidence-based care by clarifying clinical responsibility and ensuring longitudinal management within primary care. Osteoporosis should be treated as a chronic disease rather than an isolated event. Closing post-fracture care gaps requires a Physician Associate-supported primary care model that clarifies clinical responsibility and ensures longitudinal management. By incorporating automated identification, standardized evaluation, individualized treatment, exercise referral, and scheduled follow-up, this framework is essential for reducing recurrent fragility fractures.

Recommended Citation

Lybarger LM. Coordinated Osteoporosis Management in Primary Care to Prevent Fragility Fractures. University of Lynchburg Doctoral Project Assignment Repository. 2026; 8(3).