General and Specific Considerations as to why Osteoporosis-Related Care Is Often Suboptimal
Elizabeth Mary Curtisa b✉, Stephen J Woolfordb, Claire Holmesc, Cyrus C. Cooperb d e, Nicholas C. Harveyb e
- aMRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK. bc@mrc.soton.ac.uk
- bMRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
- cRheumatology Department, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- dNIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK
- eNIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, University of Southampton, Southampton, UK
- ✉Corresponding author
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Abstract
PURPOSE OF REVIEW: The assessment of fracture risk and use of antiosteoporosis medications have increased greatly over the last 20-30 years. However, despite this, osteoporosis care remains suboptimal worldwide. Even in patients who have sustained a fragility fracture, fewer than 20% actually receive appropriate antiosteoporosis therapy in the year following the fracture. There is also evidence that treatment rates have declined substantially in the last 5-10 years, in many countries. The goal of this article is to consider the causes for this decline and consider how this situation could be remedied. RECENT FINDINGS: A number of possible reasons, including the lack of prioritisation of osteoporosis therapy in ageing populations with multimorbidity, disproportionate concerns regarding the rare side effects of anti-resorptives and adverse changes in reimbursement in the USA, have been identified as contributing factors in poor osteoporosis care. Improved secondary prevention strategies; screening measures (primary prevention) and appropriate, cost-effective guideline and treatment threshold development could support the optimisation of osteoporosis care and prevention of future fractures.
TL;DRImproved secondary prevention strategies; screening measures (primary prevention) and appropriate, cost-effective guideline and treatment threshold development could support the optimisation of osteoporosis care and prevention of future fractures. (Semantic Scholar)