Challenges in osteoporosis awareness and management: results from a survey of US postmenopausal women

Abstract

Background: Osteoporotic fractures are a serious public health burden, leading to excess morbidity, mortality, and high costs for post-fracture care. Objectives: To evaluate the perception of osteoporotic fracture risk and to identify potential barriers associated with osteoporosis diagnosis and treatment in US postmenopausal women. Methods: An online survey was conducted by The Harris Poll in 2017 that included 1,012 postmenopausal women 50 years and older. The survey comprised eight screening questions and 35 mandatory questions pertaining to lifestyle, general health, bone fracture awareness, osteoporosis, and demographics, with additional follow-up questions where applicable. An oversample of 102 women with osteoporosis and a fragility fracture (from a fall from a standing height or lower) yielded a total of 280 subjects with osteoporosis and a fracture. Results: A total of 1,012 postmenopausal women were included in the survey; 501 self-reported a diagnosis of osteoporosis and 511 had no known osteoporosis diagnosis. Ninety-six percent of women with a first fracture but no osteoporosis diagnosis did not recall being told by their physicians that their fracture might be related to osteoporosis. Forty-four percent of respondents reported that they had not undergone screening for osteoporosis. Among those considered at risk for osteoporosis, 42% had not undergone screening. Only 45% of women surveyed agreed that a fracture is "a potential sign of more fractures/breaks to come". Twenty-four percent believed there is no way to build new bone at their age; 18% answered that they could not do much to reduce the risk of fracture at their age. Conclusions: This survey reveals a lack of awareness of the diagnosis of osteoporosis and osteoporotic fracture risk among postmenopausal women. Future studies evaluating the perceptions of osteoporosis and its management are warranted.

Keywords: Osteoporosis; crisis; fracture; treatment; treatment gap.

Figure 1.

Respondents’ perceived cause of most recent fracture. ^ap < 0.05; t-tests were conducted at the 95% confidence level (CL), therefore representing a p-value < 0.05. ^bOwing to sample size <100, these results are directional in nature.

Figure 2.

Awareness of risk factors for osteoporosis by postmenopausal women. ^ap < 0.05. t-tests were conducted at the 95% confidence level (CL), therefore representing a p-value < 0.05. ^bNo current osteoporosis and at least one of the following: menopausal before age 45 years; rheumatoid arthritis; prior fracture; breast cancer; current smoker; >3 alcoholic drinks/day, has taken a glucocorticoid for >3 months at a time; mother, father, or sister has osteoporosis.

Figure 3.

Perceptions of the etiology and prognosis of osteoporosis by postmenopausal women. ^ap < 0.05. t-tests were conducted at the 95% confidence level (CL), therefore representing a p-value < 0.05.

Figure 4.

Referral for follow-up after a fracture from falling from a standing position or less. ^aRespondents included here all saw an HCP after experiencing their fracture. ^bOwing to sample size <100, these results are directional in nature.