Osteoporosis is a medical condition affecting the bones. Osteoporotic bones lose minerals, such as calcium, more quickly than the body can replace them. This leads to loss of bone thickness (bone density or mass) which makes the bones weak, brittle and fragile. Bone loss can be caused by hormonal changes, or a deficiency of calcium or vitamin D.

Osteoporosis affects both men and women. While osteoporosis can occur at any age, it is commonly seen in older people and especially older women. After age 50, one in five women and one in three men will experience a bone fracture over the remainder of their lifetime. For women, the risk of hip fracture is higher than the combined risks of breast, ovarian and uterine cancer.2 Men are more likely to experience a hip fracture than prostate cancer.2

The Osteoporosis Risk and Management (ORMA) Project is a collaborative initiative aiming to increase the diagnosis and improve management of osteoporosis in older Australians.

ORMA is a collaborative research project, involving the following collaborators:

Melbourne Academic Centre for Health (MACH) members

  • University of Melbourne [UoM (Australian Institute for Musculoskeletal Science (AIMSS)]
  • Western Health [WH]
  • Austin Health [AH] and

PenCS (a provider of health analytics based in Melbourne, including the Clinical Audit Tool (CAT)).

The ORMA project aims to help GPs easily identify patients at risk of osteoporotic fractures at an early stage and facilitates appropriate management of individuals already diagnosed with osteoporosis.

The ORMA project will involve the use of a Clinical Audit Tool (CAT) module, called CAT-Osteoporosis which will assist with the identification of patients at risk of osteoporosis and people with established disease.

The primary objective of ORMA is to increase the proportion of patients identified with osteoporosis risk factors. There are also several secondary objectives, as outlined below:

  • Increasing the proportion of patients tested for osteoporosis.
  • Increasing the proportion of patients with a documented diagnosis of osteoporosis.
  • Increasing the proportion of patients meeting the recommended guidelines for disease treatment (secondary prevention).

The CAT (Clinical Audit Tool) is a platform widely used by general practices in Australia and works alongside the medical practice software to provide insightful population characteristics. The CAT rapidly and efficiently provides essential population health data, charts and reports, which can be used by general practice staff to drive system changes to improve patient health outcomes.

CAT- Osteoporosis is a newly created tool in CAT. The ORMA Project will evaluate the clinical significance of the use of this new tool in the primary care setting. The investigators responsible for initiating the ORMA study (steering committee) have previously developed a similar tool for the identification and treatment of other chronic diseases.

CAT-Osteoporosis is based on the ‘Osteoporosis Prevention, Diagnosis and Management in Postmenopausal Women and Men over 50 Years of Age Guidelines’ developed by the Royal Australasian College of General Practitioners (RACGP) 2017.

The ORMA Project is a randomised stepped wedge study aimed to assess the effectiveness of the CAT-Osteoporosis clinical audit tool to prevent osteoporotic fractures in patients and to enhance the management of patients already diagnosed.

ORMA will report on the proportion of patients:

  1. Identified with osteoporosis risk factors (primary prevention).
  2. Tested for osteoporosis.
  3. With a documented diagnosis of osteoporosis.
  4. Meeting the recommended guidelines for disease treatment (secondary prevention).

General practices located in Victoria can take part in the ORMA study provided they meet the criteria listed in the Information Sheet (click here).


2. PR Ebeling, Osteoporosis in Men: Why Change Needs to Happen, ed P Mitchell, International Osteoporosis Foundation, Switzerland, 2014, p2. (or ref 1 below)

3. ABS (Australian Bureau of Statistics) 2018. National Health Survey: First Results, 2017–18. ABS cat. no. 4364.0.55.001. Canberra: ABS.

4. https://www.osteoporosis.org.au/burdenofdisease

5. https://www.populationpyramid.net/australia/2022/ [Accessed 9 DEC 2019].

6. https://www.statista.com/statistics/263740/total-population-of-australia/ [Accessed 9 DEC 2019].

7. Shepstone L et al. SCOOP Study Team. Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. 2018 Feb 24;391(10122):741-747

8. Ewald D. Osteoporosis - prevention and detection in general practice. Aust Fam Physician. 2012 Mar;41(3):104-8.