Recomendaciones Sociedad Española de Investigación Ósea y Metabolismo Mineral (SEIOMM)-SEMERGEN-semFYC-SEMG para el manejo de los pacientes con osteoporosis/fractura por fragilidad en atención primaria

Osteoporosis is characterized by decreased bone mineral density and deterioration of bone microarchitecture, leading to increased skeletal vulnerability and susceptibility to fracture. These fractures impose a substantial clinical, social, and economic burden, significantly elevating morbidity and mortality. However, a relevant gap persists in diagnosis and therapeutic management, particularly within primary care. This document presents the first consensus recommendations developed by four scientific societies (SEIOMM, SEMERGEN, semFYC, and SEMG), derived from a Delphi process and supported by the most current scientific evidence. Its objective is to unify clinical criteria and improve coordination across healthcare levels. The recommendations are structured around: identification and assessment of fracture risk, treatment, follow-up, and referral criteria. The use of 10-year fracture risk assessment tools such as FRAX (Fracture Risk Assessment Tool) and dual-energy X-ray absorptiometry (DXA) is proposed for risk stratification, and clear guidelines are established for initiating treatment based on the patient's profile. The importance of treatment adherence, periodic reassessment, and patient participation in decision-making is emphasized.