By 2025 some 500 million people will be living with osteoporosis, a chronic disease which weakens bones and leaves older adults at risk of a fragility fracture - a broken bone which typically occurs after a low-trauma fall. As a result, an estimated 13.5 million fragility fractures will occur worldwide.
Fragility fractures affect older adults, and with the emergence of hyper-aging societies in which over 25% of the population is aged above 65 years, the rapidly increasing fracture incidence will pose a growing burden to health care systems all over the world. Hip fractures, the most life-threatening and costly of osteoporosis-related fractures, are expected to increase by 310% in men and 240% in women by 2050 compared to rates in 1990.
Despite the obvious and urgent need to prioritize fragility fracture prevention, there is currently a glaring care gap in which up to 80% of those who have already broken a bone are not being identified and treated with effective therapies. People who have sustained an initial fragility fracture are five times more likely to fracture again, compared to those who have not fractured.
When one fragility fracture occurs, a patient is at imminent risk of sustaining subsequent fractures. Nevertheless, only 20% of fragility fracture patients are currently offered screening or treatment for osteoporosis, the underlying disease. Given the immense and growing burden of fragility fractures, it is clear that health care strategies must be put in place to reduce this unacceptable care gap."
Professor Cyrus Cooper, IOF President, Professor of Musculoskeletal Science, University of Oxford, Southampton, UK
As well as their devastating impact on patients' long-term health and independence, fragility fractures cost global healthcare systems around USD 400 billion each year and account for approximately 3% of healthcare costs.
This is significantly higher than health care costs for many other common conditions, including stroke and coronary heart disease. However, whereas patients at risk of cardiovascular events are routinely screened and prescribed risk-reducing medications, osteoporosis still remains vastly underdiagnosed and undertreated.
The new policy guidance issued by the International Osteoporosis Foundation (IOF) under the framework of the Capture the Fracture® Partnership, makes the case for fracture prevention and shows the clear public health and financial benefits of Post-Fracture Care (PFC) Coordination Programs, also known as Fracture Liaison Services. When widely implemented, such programs represent the most effective strategy to address the fragility fracture crises affecting older populations worldwide.
'Capture the Fracture® Partnership: Guidance for Policy Shaping, available on the Capture the Fracture® website, describes how and why coordinated, multidisciplinary systems of Post-Fracture Care are critical to building an effective policy response.
The Guidance outlines the generic components of global, regional and national calls to action, explains the need for Post-Fracture Care program implementation and provides a step-by-step policy guide to help health care authorities and Post-Fracture Care coordinators evaluate their programs in hospitals and health systems worldwide. The Guidance urges policy makers to ensure that the following four key building blocks are reflected in their health care policy:
- Catch fractures early: Ensure that those who have sustained a fragility fracture are identified for treatment
- Treat fractures well: Employ world-class models of post-fracture care to treat those identified
- Promote lifetime prevention: Encourage healthy aging through straightforward public health measures
- Enhance engagement: Empower the public to understand the problem and become part of the solution.
IOF CEO Dr. Philippe Halbout added:
"This new document shows that there is an overwhelming humanitarian and health economic case to be made for the implementation of secondary fracture prevention strategies, and specifically Post-Fracture Care programs. Osteoporosis-related fractures of the hip and spine in older adults are associated with increased risk of death and long-term disability, more frequent hospital admissions, and loss of independence. This impacts heavily on family caregivers and all too often leads to nursing home admission."
"As the world's largest organization dedicated to bone health and osteoporosis prevention, IOF strongly urges the implementation of Post-Fracture Coordination Programs in all hospitals which treat fracture patients. Such coordinated, multi-disciplinary services represent a clear, achievable solution to the fragility fracture crisis."
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