Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Feb;19(1):58-65.
doi: 10.1007/s11914-020-00644-w. Epub 2021 Jan 9.

Closing the Osteoporosis Care Gap

Kristina E Åkesson  1   2 , Fiona E A McGuigan  3   4
Affiliations
Review

Closing the Osteoporosis Care Gap

Kristina E Åkesson et al. Curr Osteoporos Rep. 2021 Feb.

Abstract

Purpose of review: This review outlines the scope of the problem in osteoporosis care and secondary fracture prevention and describes fracture prevention strategies, with a focus on the frail elderly.

Recent findings: Despite heightened awareness among patients and clinicians alike and the availability of efficacious anti-osteoporosis medications, osteoporosis is still underdiagnosed and undertreated. However, the introduction of systematic risk assessment and secondary fracture prevention programmes has gained momentum, and evidence of success is accumulating. We possess today the knowledge required to close the osteoporosis care gap. The basic components in a secondary prevention model are similar in all health care settings, number one being a dedicated fracture coordinator, with anti-osteoporosis medications and multifaceted falls prevention as cornerstones, particularly in the frailest, both in the near and long-term. Initiation of structured care pathways including the key elements - identification, investigation, intervention and follow-up of adherence - demonstrably reduces re-fracture rates and is cost-effective.

Keywords: Elderly; Fracture; Fracture liaison service; Frailty; Prevention.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Age- and type-specific fracture pattern
Fig. 2
Fig. 2
The interaction between risk factors for fracture, falls, frailty, fracture and re-fracture
Fig. 3
Fig. 3
Change in patient outcomes after osteoporosis-related fractures when managed through fracture liaison service (FLS) programmes
See this image and copyright information in PMC

References

    1. Beard JR, Officer A, de Carvalho IA, Sadana R, Pot AM, Michel JP, Lloyd-Sherlock P, Epping-Jordan JAE, Peeters GMEE(G), Mahanani WR, Thiyagarajan JA, Chatterji S. The world report on ageing and health: a policy framework for healthy ageing. Lancet. 2016;387(10033):2145–2154. - PMC - PubMed
    1. Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA, 3rd, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15(4):721–739. - PubMed
    1. Kanis JA, Johnell O, De Laet C, Johansson H, Oden A, Delmas P, et al. A meta-analysis of previous fracture and subsequent fracture risk. Bone. 2004;35(2):375–382. - PubMed
    1. Johansson H, Oden A, McCloskey EV, Kanis JA. Mild morphometric vertebral fractures predict vertebral fractures but not non-vertebral fractures. Osteoporos Int. 2014;25(1):235–241. - PubMed
    1. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17(12):1726–1733. - PubMed

Publication types

Substances