雄激素剥夺疗法（ADT）是前列腺癌（PCa）的主要治疗方法，会增加骨质疏松和脆性骨折的风险。尽管有降低骨折风险的国际指南，但由于实施不力，骨质疏松症的诊断和治疗不足。本次范围界定审查旨在综合围绕指南实施的知识，为卫生服务干预措施提供信息，以降低接受 PCa 接受 ADT (PCa-ADT) 的男性骨折风险。检索了 4 个数据库和其他文献，查找 2000 年 1 月至 2023 年 1 月期间发表的研究提供影响指南实施的证据的研究也被纳入其中。 i-PARIHS（促进卫生服务研究实施行动）实施框架用于为叙述综合提供信息。在确定的 1229 项研究中，9 项研究符合纳入标准。总体而言，在异质研究设计和结果测量中观察到骨折风险评估有所改善。六项研究来自加拿大。两项研究涉及家庭医生或社区医疗保健计划。两项研究纳入了患者或专家调查。其中之一利用了实施框架。实施障碍包括患者和临床医生缺乏知识、时间限制、不支持的组织结构以及将患者护理从专家转移到初级护理的挑战。有效的策略包括教育、采用多学科方法的新颖护理途径、将健康的骨骼处方工具纳入日常护理、护理点干预和定制诊所。为前列腺癌男性提供循证骨骼保健的需求尚未得到满足接收 ADT。这项研究强调了对 PCa-ADT 患者实施骨折风险评估的障碍和策略。初级保健临床医生可以在长期癌症治疗并发症（例如治疗引起的骨质流失）的管理中发挥重要作用。未来的研究应在服务重新设计中咨询患者、家属、专家和初级保健临床医生。© 2024。作者。

Androgen deprivation therapy (ADT) is a mainstay of treatment for prostate cancer (PCa) and is associated with increased risks of osteoporosis and fragility fractures. Despite international guidelines to mitigate fracture risk, osteoporosis is under-diagnosed and under-treated due to poor implementation. This scoping review aims to synthesise knowledge surrounding the implementation of guidelines to inform health service interventions to reduce fracture risk in men with PCa-taking ADT (PCa-ADT).Four databases and additional literature were searched for studies published between January 2000 and January 2023. Studies that provided evidence influencing guidelines implementation were included. The i-PARIHS (Promoting Action on Research Implementation in Health Services) implementation framework was used to inform the narrative synthesis.Of the 1229 studies identified, 9 studies met the inclusion criteria. Overall, an improvement in fracture risk assessment was observed across heterogeneous study designs and outcome measures. Six studies were from Canada. Two studies involved family physicians or a community healthcare programme. Two studies incorporated patient or specialist surveys. One utilised an implementation framework. Implementation barriers included the lack of knowledge for both patients and clinicians, time constraints, unsupportive organisational structures, and challenges in transferring patient care from specialists to primary care. Effective strategies included education, novel care pathways using a multidisciplinary approach, incorporating a healthy bone prescription tool into routine care, point-of-care interventions, and bespoke clinics.There is an unmet need to provide evidence-based bone healthcare in men with PCa receiving ADT. This study highlights barriers and strategies in the implementation of fracture risk assessment for PCa-ADT patients.Primary care clinicians can play a significant role in the management of complications from long-term cancer treatment such as treatment-induced bone loss. Future studies should consult patients, families, specialists, and primary care clinicians in service re-design.© 2024. The Author(s).