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Osteoporos Int. 2017 Jul;28(7):2023-2034. doi: 10.1007/s00198-017-4009-0. Epub 2017 Apr 27.

Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting.

Author information

1
Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK. w.j.Pontefract@shef.ac.uk.
2
Institute for Health and Ageing, Catholic University of Australia, Melbourne, Australia. w.j.Pontefract@shef.ac.uk.
3
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
4
NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
5
Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
6
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
7
Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.
8
Department of Surgery and Translational Medicine, Unit of Bone and Mineral Diseases, University of Florence, Florence, Italy.
9
Bone and Mineral Research Unit, Instituto "Reina Sofía" de Investigación, REDinREN ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Asturias, Spain.
10
Department of Rheumatology, Lille University Hospital, Lille, France.
11
Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
12
Department of Bone Oncology, Endocrinology and Reproductive Medicine, Krankenhaus Nordwest, Frankfurt, Germany.
13
Endonet, Endocrine Clinic and Laboratory, Basel, Switzerland.
14
Department of Orthopaedic Surgery and Osteology, Klinikum Frankfurt, Frankfurt, Germany.
15
Mayor Teaching Hospital, Charitè Medical School, Berlin, Germany.
16
Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
17
MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK.
18
Department of Internal Medicine and Medical Disciplines, "Sapienza" Università di Roma, Rome, Italy.
19
INSERM U1059, Laboratoire Biologie Intégrée du Tissu Osseux, Rheumatology Department, CHU Saint-Etienne, Université de Lyon, Saint-Etienne, France.
20
Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.

Abstract

Osteoporosis represents a significant and increasing healthcare burden in Europe, but most patients at increased risk of fracture do not receive medication, resulting in a large treatment gap. Identification of patients who are at particularly high risk will help clinicians target appropriate treatment more precisely and cost-effectively, and should be the focus of future research.

INTRODUCTION:

The purpose of the study was to review data on the identification and treatment of patients with osteoporosis at increased risk of fracture.

METHODS:

A working group convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis met to review current data on the epidemiology and burden of osteoporosis and the patterns of medical management throughout Europe.

RESULTS:

In Europe in 2010, the cost of managing osteoporosis was estimated at €37 billion and notably the costs of treatment and long-term care of patients with fractures were considerably higher than the costs for pharmacological prevention. Despite the availability of effective treatments, the uptake of osteoporosis therapy is low and declining, in particular for secondary fracture prevention where the risk of a subsequent fracture following a first fracture is high. Consequently, there is a significant treatment gap between those who would benefit from treatment and those who receive it, which urgently needs to be addressed so that the burden of disease can be reduced.

CONCLUSIONS:

Implementation of global fracture prevention strategies is a critical need. Future research should focus on identifying specific risk factors for imminent fractures, periods of high fracture risk, patients who are at increased risk of fracture and therapies that are most suited to such high-risk patients and optimal implementation strategies in primary, secondary and tertiary care.

KEYWORDS:

Fracture risk; Healthcare burden; Management; Osteoporosis; Secondary prevention; Treatment gap

PMID:
28451733
PMCID:
PMC5483332
DOI:
10.1007/s00198-017-4009-0
[Indexed for MEDLINE]
Free PMC Article

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