| Objective To analyze the effectiveness and priority of different interventions for the prevention and treatment of falls or fractures in patients with osteoporosis by using network meta-analysis. Methods The randomized controlled trials (RCTs) published before January 30, 2024, in Chinese and English databases were searched. After screening, the risk of bias assessment, and quality of evidence evaluation of the literature, network meta-analysis was performed using a Stata 14.0 software. Results Sixteen randomized controlled trials with a total of 15141 patients and 9 interventions were included. Meta-analysis showed that in the prevention of falls in patients with osteoporosis, exercise (OR=0.33, 95%CI: 0.16-0.70, P<0.05), and exercise plus medication (OR=0.46, 95%CI: 0.24-0.87, P<0.05) were effective interventions in reducing falls compared with usual interventions. SUCRA ranking results suggested that combination of exercise, environment, education, socialization, fall assessment, and assistive technology might be the priority recommended interventions for the prevention of falls in patients with osteoporosis (SUCRA=90.3%). For the prevention of fractures in patients with osteoporosis, there was no statistically significant difference in the results of the comparison of existing interventions (P>0.05). The results of the SUCRA ranking suggested that exercise might be the preferred recommended intervention for the reduction of fractures in patients with osteoporosis (SUCRA = 73.2%). Conclusion Exercise and exercise plus medication interventions are effective in reducing falls in patients with osteoporosis. Among various fracture prevention interventions, exercise may be a preferred recommendation. However, the quality of the evidence is not good enough for the current findings. |