Top 10 solutions to reduce the global burden of fragility fractures

The health care landscape of countries varies around the world, but most share a common drawback: osteoporosis and fracture prevention are not prioritized in the health care system.

Osteoporosis is a chronic, progressive disease that causes bones to become weak and brittle, leading to a high risk of fractures, known as ‘brittle fractures’. In people with osteoporosis, bones can break after a slight fall from a standing height, impact, or even a sneeze. Globally, about one-third of women and one-fifth of men over the age of 50 will have a bone fracture due to osteoporosis – usually in the spine, wrist or hip.

Fragility fractures lead to costly surgeries, hospitalizations and rehabilitation and, in many cases, place a heavy burden on family caregivers or result in the need for long-term nursing home care . For patients, quality of life, mobility, and independence are greatly affected and the risk of death increases: approximately 24% of hip fracture patients die within a year of the fracture. bone. In Europe alone, more than 4.3 million osteoporotic fractures occurred in 2019, causing losses of nearly 57 billion euros.

Dr Philippe Halbout, CEO of the International Osteoporosis Foundation (IOF) said:

“As populations age worldwide, we can expect the number of osteoporotic fractures to increase. By 2050, the global incidence of hip fractures is predicted to increase by 310% in men and 240% in women, compared to 1990 rates. For this reason, osteoporosis and fracture prevention must be priorities. emergency in health care systems.”

Without treatment for osteoporosis, patients who have had a fracture are at risk for additional fractures within the next one to two years. In fact, up to half of patients who come to the hospital with a hip fracture have broken another bone in the months or years before the hip fracture.

Professor Maria Luisa Brandi, President of IOF Capture the crack® program, also note:

“It is extremely important that all patients with previous fractures receive timely intervention and treatment for osteoporosis to prevent further fractures. Unfortunately, the vast majority of people with a first fracture are not evaluated for osteoporosis. Indeed, studies have shown that approximately 80% of fracture patients worldwide are neither evaluated nor treated for osteoporosis, the underlying disease. This is despite the availability of safe and effective medications and clear medical management guidelines requiring treatment and monitoring.”

IOF experts, in collaboration with national osteoporosis experts, have identified many important actions that health care systems can take to help prevent osteoporotic fractures in the population. These have been outlined in recent IOF publications including the Capture the Fracture® policy audit and reports, the key report Capturing the Fracture Partnership’s Guide to Shaping Policy and Reporting SCOPE Summary report: Scorecard for Osteoporosis in Europe. While each country has its own specific healthcare context, priorities and challenges, there are some common key components of any effective strategy to address the fracture crisis. due to bone fracture.

The top 10 policy actions include:

  1. Compulsory osteoporosis as one National Health Priorities with the implementation of national and/or regional action plans.
  2. Widely deployed Fracture Liaison Service for the regular assessment, management, and follow-up of all individuals with low-trauma fractures.
  3. Ensure High quality information of disease burden through a national fracture registry, including clinical hip and vertebral fractures.
  4. Provide to return for approved treatments to ensure access for all people at high risk of fracture.
  5. Ensure exact identification of patients at risk of fracture through access to and provision of a full range of DXA services and emerging technologies, as well as FRAX.
  6. Develop and disseminate high quality management instructions osteoporosis, including guidance on the use of risk assessment tools and ensuring that they are widely used in clinical practice.
  7. Reduce waiting time for surgery after hip fracture, as this is associated with significantly reduced mortality and better patient outcomes.
  8. Provide High quality training in osteoporosis, including the primary care of osteoporosis patients and ensuring that osteoporosis is a recognized and established part of specialty training.
  9. Strong and effective support patient organization can advocate on behalf of patients, work to raise public awareness and work closely with medical and research associations.
  10. Deploy systems to measure and test quality of care provided to people with osteoporosis and related fractures.

IOF President, Professor Cyrus Cooper said:

“In the context of World Osteoporosis Day, I strongly urge all health authorities to consider osteoporosis and fracture prevention as a health care priority. We must address this paradox: the explosion of fragility fractures as the population ages, compared with the unacceptable osteoporosis treatment gap that results in huge human and socioeconomic costs. big. Furthermore, although the implementation of post-fracture care programs such as fracture liaison services is growing, we need to increase the provision of these essential services, which are still rare in most countries. family.

“With the expected increase in fracture burden, we absolutely must do better. The 10 key actions we have identified can help save lives, reduce costs and improve the quality of life of older people in countries around the world.”


About osteoporosis
Osteoporosis is a condition in which bones become thin and lose strength as they become less dense and their quality declines. This leads to a high risk of fractures or ‘fragility fractures’ occurring after a slight slip from a standing height or simply from a sudden impact or movement. Osteoporosis is often called a “silent” disease because there are no obvious symptoms until a bone breaks.
• Osteoporosis is the main cause of bone fractures in postmenopausal women and older men. Osteoporosis-related fractures occur most often in the hips, vertebrae in the spine, and the wrists.
• Many effective drugs have been approved for the treatment of osteoporosis worldwide. These medications are often used in combination with calcium and vitamin D supplements, as well as recommendations for lifestyle changes, adequate nutrition, and targeted exercise.
• According to the WHO definition of osteoporosis, the disease affects approximately 21.2% of women and 6.3% of men over 50 years of age and in the same age group globally. Based on the world population, this suggests around 500 million women and men could be affected globally.
More information as well as facts and statistics about osteoporosis are available on the IOF website.

Introducing IOF

The International Osteoporosis Foundation (IOF) is the world’s largest non-governmental organization dedicated to the prevention, diagnosis and treatment of osteoporosis and related musculoskeletal diseases. IOF members, including committees of scientific researchers as well as 325 research, medical and patient organizations, work together to make fracture prevention and healthy mobility priorities. healthcare pioneers worldwide. @iofbonehealth

World Osteoporosis Day marked on October 20 every year:

Introduction to Fracture Imaging®

Capture the fracture® (CTF) is a multi-stakeholder initiative, led by the International Osteoporosis Foundation, to facilitate the implementation of Post-Fracture Care Coordination (PFC) Programs, such as such as the Fracture Liaison Service (FLS), for secondary fracture prevention. The CTF initiative aims to promote changes at the local and regional level to prioritize secondary fracture prevention. It sets global best practice standards and provides accreditation for the Fracture Liaison Service (FLS) through the Best Practice Framework. The CTF also provides the resources and materials needed to build a prioritization base for secondary fracture prevention and help promote the implementation and quality improvement of FLS. Mentoring programs that support FLS development at the local level are also offered. Currently, the CTF network includes more than 875 FLS in 55 countries worldwide. FLS are invited to apply for free assessment and accreditation through the CTF website’s online Best Practice Framework Questionnaire platform. #CaptureTheFracture

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