OBJECTIVES: Osteoporosis is a silent disease that is underdiagnosed and undertreated. The discrepancy between and complexity of management guidelines hinder case-finding and treatment and thus fracture prevention. As a result, society bears high costs for the treatment of osteoporotic fractures and their consequences. To improve cost-effectiveness of osteoporosis management, feasible and practical guidelines are a prerequisite. As guideline adoption is impaired by barriers at different levels, careful considerations should be made in their development and implementation.

METHODS: A literature analysis was conducted to identify frequent barriers in osteoporosis management. Recent international guidelines for primary care osteoporosis management were compared and draft guidelines for practical implementation were produced. This was reviewed by a Scientific Steering Committee (SCC) of medical stakeholders in osteoporosis care and a consensus sought. Experts in clinical osteoporosis management were consulted to provide remarks. The result was again presented to the SCC. This process was repeated until final consensus was reached. The guidelines were then presented to 24 family physicians on paper and during a face-to-face educational session, during which they assessed the feasibility.

RESULTS: A one page flowchart for osteoporosis management in postmenopausal women with and without comorbidity, including case-finding strategy, was endorsed. Reimbursement criteria for DXA and anti-resorptive therapy in Belgium were thereby accounted for. Family physicians’ personal barriers in knowledge and attitude were tackled during the personal educational session, resulting in a high willingness for implementation. All family physicians rated the flowchart as ‘highly feasible’ at first encounter.

CONCLUSIONS: The use of a SCC representing all stakeholders in osteoporosis management can increase guideline feasibility without compromising on scientific evidence. A personalized educational approach in family physicians can lead to a higher implementation willingness and decreased scepticism. Therefore, this might be a useful strategy to improve cost-effectiveness in diseases lacking unambiguous or adequate case-finding and treatment strategies.