Prevalence of FRAX risk factors and the osteoporosis treatment gap among women ≥ 70 years of age in routine primary care across 8 countries in Europe

Abstract

Summary We studied whether elderly women at risk for fractures receive primary care treatment to prevent fracture. We found that across Europe, women at risk are often not identified, and less than half of such women receive appropriate treatment. Finally, women diagnosed with osteoporosis are much more likely to receive treatment. Purpose To examine the relationship between risk factors for fragility fracture (FF) and osteoporosis (OP) treatment gap in elderly women across Europe, and compare the prevalence of risk factors between countries. Methods Demographic and clinical information was collected from women ≥ 70 years visiting primary care physicians in Belgium, France, Germany, Ireland, Poland, Slovakia, Switzerland, and the UK. Increased risk of FF was defined by the presence of 1 or more criteria (history of fracture, 10-year fracture probability, or T-score ≤ − 2.5). Results There were 3798 women in total. Treatment gap (proportion at increased risk of FF not receiving treatment for OP) varied from 53.1 to 90.8% across countries, and the proportion of patients at increased risk of FF varied from 41.2 to 76.1%. Across countries, less than 50% of patients with increased risk of FF had a diagnosis of OP. Previous fracture was the most common risk factor, with similar prevalence across most countries; other risk factors varied widely. The treatment gap was reduced in patients with an OP diagnosis in all countries, but this reduction varied from 36.5 to 79.4%. The countries with the lowest rates of bone densitometry scans (Poland, France, and Germany; 8.3–12.3%) also had the highest treatment gap (82.2 to 90.8%). Conclusions This study highlights differences across Europe in clinical risk factors for fracture, rates of densitometry scanning, and the rates of OP diagnosis. More emphasis is needed on risk assessment to improve the identification and treatment of elderly women at risk for fracture.

Osteoporosis-related characteristics in care home residents in England: a retrospective cohort study

“…Low osteoporosis diagnosis rates are associated with low treatment rates and contribute to the osteoporosis treatment gap in primary care. 39 , 40 …”

“…We found only 22% of care home residents to have a diagnosis of osteoporosis recorded following a fracture. Low osteoporosis diagnosis rates are associated with low treatment rates and contribute to the osteoporosis treatment gap in primary care (39,40).…”

Hypertension and reduced bone mineral density: unexpected pathogenetic mechanisms

“…Стоит обратить внимание на исследование McCloskey E, et al ( 2022), где оценивалась распространенность клинических факторов риска, используемых при прогнозировании 10-летней вероятности перелома (Алгоритм FRAX ® ), и недочеты в лечении остеопороза среди женщин ≥70 лет (n=3798) в условиях первичной медико-санитарной помощи в 8 странах Европы [10]. Остеопороз не был диагностирован у большинства пациенток при обращении за первичной медико-санитарной помощью.…”

“…У участниц, обратившихся на консультацию к врачу первичного звена, было как минимум 1 сопутствующее заболевание (83,2% в Ирландии и 94,9% в Польше). Наиболее распространенной сопутствующей патологией была артериальная гипертензия (АГ) (от 61,8% в Великобритании до 91,2% в Словакии), а наименее распространеннойревматоидный артрит (от 3,2% в Ирландии и Польше до 5,0% во Франции) [10].…”

Nuevas aproximaciones en la evaluación de factores predictores de fractura osteoporótica en mujeres postmenopaúsicas

“…Por ejemplo, el estudio GLOW, en el que se estudió a 51762 mujeres de todo el mundo; encontró que la edad y las fracturas previas en diferentes localizaciones son factores de riesgo importantes para la fractura osteoporótica (199). Otro estudio multicéntrico encontró que las mujeres mayores de 70 años con fractura previa tienen un mayor riesgo de fractura osteoporótica (200).…”