General and Specific Considerations as to why Osteoporosis-Related Care Is Often Suboptimal

Abstract

Purpose of Review The assessment of fracture risk and use of antiosteoporosis medications have increased greatly over the last 20-30 years. However, despite this, osteoporosis care remains suboptimal worldwide. Even in patients who have sustained a fragility fracture, fewer than 20% actually receive appropriate antiosteoporosis therapy in the year following the fracture. There is also evidence that treatment rates have declined substantially in the last 5-10 years, in many countries. The goal of this article is to consider the causes for this decline and consider how this situation could be remedied. Recent Findings A number of possible reasons, including the lack of prioritisation of osteoporosis therapy in ageing populations with multimorbidity, disproportionate concerns regarding the rare side effects of anti-resorptives and adverse changes in reimbursement in the USA, have been identified as contributing factors in poor osteoporosis care. Summary Improved secondary prevention strategies; screening measures (primary prevention) and appropriate, cost-effective guideline and treatment threshold development could support the optimisation of osteoporosis care and prevention of future fractures.

Neuroendocrine neoplasia and bone (Review)

“…The economic burden related to low-trauma fractures is reflected in associated costs of $17.9 up to £4 billion/year in the UK and the US due to the fact that currently osteoporosis is undertreated (19). These days, less than one fifth of osteoporotic patients receive medication for this diagnosis, and the current rate is not increasing due to multiple causes such as the presence of other co-morbidities (especially age-dependent) that also require medication where osteoporosis is not considered a priority; the fear of side effects of anti-osteoporotic drugs; and difficulties of anti-osteoporosis medication reimbursement protocols depending on countries (20).…”

Risco de fratura osteoporótica em portadores de doença pulmonar obstrutiva crônica

“…Adas-Okuma et al corroboram esse achado, relatando que para o mesmo T-score, indivíduos com DPOC tinham 4,7 vezes mais chance de fratura que indivíduos saudáveis (Okuma et al, 2020). Dessa forma, a analise somente da DMO é ineficaz em predizer a saúde óssea nessa população e a melhor estratégia para prevenção primária é a identificação, por parte do médico, dos fatores de risco clínicos (Curtis et al, 2020).…”

The Value of Cement Augmentation in Patients With Diminished Bone Quality Undergoing Thoracolumbar Fusion Surgery: A Review

“… 1 Although there have been major advances in the diagnosis and treatment of this disease, osteoporosis and bone health care remains suboptimal. 2 As such, osteoporosis and bone quality are important factors for all spine surgeons to consider when planning thoracolumbar (TL) fusion surgery. 3 …”