INTRODUCTION: Currently identification, and therefore, management of patients at 
risk of osteoporotic fracture in the UK is suboptimal. As the majority of 
patients who fracture have fallen, it follows that people who fall can usefully 
be targeted in any programme that aims to reduce osteoporotic fracture. 
Targeting vulnerable patients who are likely to benefit from intervention may 
help shift the management of fracture prevention into primary care, away from 
emergency departments. Paramedics who attend to patients who have fallen may be 
well placed to assess future fracture risk, using the Fracture Risk Assessment 
Tool (FRAX) and communicate that information directly to general practitioners 
(GPs).
METHODS AND ANALYSIS: This feasibility study takes the form of a pragmatic, 
randomised controlled trial aimed at exploring and refining issues of study 
design, recruitment, retention, sample size and acceptability preceding a 
large-scale study with fracture as the end point. Patients (aged >50) who fall, 
call an ambulance, are attended by a study paramedic and give verbal consent 
will be asked FRAX and fall questions. Patients who subsequently formally 
consent to participation will be randomised to control (usual care) or 
intervention groups. Intervention will constitute transmission of calculated 
future fracture risk to the patients' GP with suitable, evidence-based 
recommendations for investigation or treatment. 3 months after the index fall, 
data (proportion of patients in each group undergoing investigation or starting 
new treatment, quality of life and health economic) will be collected and 
analysed using descriptive statistics. A nested qualitative study will explore 
issues of acceptability and study design with patients, paramedics and GPs.
ETHICS AND DISSEMINATION: This protocol was approved by NRES Committee South 
Central Oxford C in October 2012. Research Ethics Committee ref.12/SC/0604. The 
study findings will be disseminated through peer-reviewed journals, conference 
presentations and local public events. A publication plan and authorship 
criteria have been preagreed.
TRIAL REGISTRATION NUMBER ISRCTN: 36245726.