Design of the SALT Osteoporosis Study: a randomised pragmatic trial, to study a primary care screening and treatment program for the prevention of fractures in women aged 65 years or older

Table 1 Risk factors for fractures according to the Dutch guideline for general practitioners (GP) for primary osteoporosis

Risk factor	Risk score
Vertebral fracture	4
Recent fracture (<2 years) after the age of 50 years	4^a
Age ≥ 70 years	1
Age ≥ 60 years	1
Non recent fracture after the age of 50 years	1
Additional non recent fracture after the age of 50 years at a separate occasion	1
Parental hip fracture	1
Body weight < 60 kg	1
Severe immobility or 1 fall or more in the last year	1

Bone densitometry and morphological assessment of vertebral fractures (unless a vertebral x-ray has already been performed) is indicated if the total risk score is ≥4 points. Subsequently bisphosphonate treatment for 5 years is advised if the bone mineral density (BMD) of either femoral neck or lumbar spine shows a T-score ≤ −2.5 or if a prevalent vertebral fracture (≥25% height reduction) is present^a
^aIn October 2012, when the trial had already started, the Dutch guidelines for GP’s for primary osteoporosis were updated [11]. In the previous guidelines, the treatment threshold of BMD (femoral neck or spine) was a T- score < −2.5 for patients aged <70 years, or a Z-score ≤ −1 for patients aged ≥70 years