This study confirms that osteoporosis is underdiagnosed, undertreated and imposes a considerable economic burden on the health system in Germany. Effective strategies for the prevention and management of this disease are needed.

SUMMARYBackground: Osteoporosis is a widespread disease of the skeleton that becomes more common with advancing age. Its prevalence is still inadequately documented. The goal of this study is to determine how common osteoporosis is in Germany.

These results show that posttransplant clinical outcomes result in a significant increase in treatment costs. Because the economic impact of primary causes of chronic rejection (acute rejection and CMV) and delayed graft function is substantial, careful selection of the most appropriate immunosuppressive regimen is essential.

The increasing political importance of patients' attitudes and satisfaction for the development of policy measures to ensure and improve the quality of care is beyond doubt. To make sure that the measurement of patient satisfaction does not only serve to meet regulatory requirements but helps to improve the quality of care and provides reliable data for health services research, a high standard is required for the questionnaires to be used. The Qualiskope-A and only few other instruments meet this high standard.

In Germany, the number of patients with osteoporosis-attributable fractures is high. There are still deficits in proper treatment as well as in drug persistence. Low persistence lead to a relatively high proportion of patients with follow-up fractures.