What are the wider health impacts of COVID-19 on fracture patients served through Ontario's province-wide Fracture Screening and Prevention Program?

A fragility fracture happens after a slip, trip, or fall from standing height or less (e.g. slipping on ice and breaking a wrist). Over 131,000 Canadians have one of these fractures every year. This type of fracture predicts future fractures, such as devastating hip fractures, and is a sign of poor bone health that requires treatment. Fractures generally happen in women and older individuals with other chronic health conditions. The Fracture Screening and Prevention Program is a program that runs in 34 Ontario fracture clinics. Through the program, coordinators see about 8,000 patients per year. They arrange for patients to get a bone mineral density test, referral to a specialist, and treatment that may include medication. COVID has disrupted fracture patients' access to health care worldwide but little is known how it has affected Canadian fracture patients. Our goal is to determine how COVID has affected fracture patients in Ontario. We will analyze data from the Fracture Screening and Prevention Program to see how COVID has affected patients' access to testing, specialists, and treatment. We will also interview coordinators who work in the fracture clinics to ask about their experiences with helping patients in the program. Finally, we will interview patients from fracture clinics in the program to ask them about their experiences with their fracture and their bone health, such as getting to specialist appointments. Our research will inform the development of interventions to help fracture patients during a pandemic like COVID. For example, we might offer virtual visits with a specialist or pharmacist to talk with patients about the prescribed medication. It is important that fracture patients follow bone health treatment recommendations because treatment can prevent future fractures like a hip fracture. This will help decrease health care costs in Canada related to fractures, including admission to hospital, extended care facilities, and nursing homes.